superdelegate pledge form final
DESCRIPTION
Superdelegate Pledge Form FINALTRANSCRIPT
Pledge DelegateThe Democratic National Committee collects demographic information on each delegate to ensure that affirmative action goals are met. Therefore, the following information is required on every delegate:
Name
Mailing Address
City State ZIP
Mobile
Secondary Telephone
Gender (M/F)
Post Office Box 5256, New York, NY 10185 • www.hillaryclinton.comContributions or gifts to Hillary for America are not tax deductible.
Paid for by Hillary for America
Affirmative Action Information Please check appropriate groups
African American Hispanic/Latino AAPI Arab American Native American If so, tribe:
Youth LBGT Disabled Veterans
To file by mail: ATTN: David Huynh, Hillary for America, PO Box 5256, New York, NY 10185
To file by fax: 202.478.2640; call 646.854.1160 to confirm receipt
To file by email: [email protected]
Your signature Date
I, , pledge to support Hillary Rodham Clinton at the 2016 Democratic National Committee Convention with my unpledged delegate vote.