Sign-up Page for Broomfield Republican Caucus 2018

March 6th -- 7:00pm - doors open at 6:15pm
       Broomfield Heights Middle School
    1555 Daphne Street, Broomfield, CO  80020

Make sure you hit the "Submit" button
       at the bottom when complete
  

Broomfield Republicans 2018 Caucus - Pre Registration Form
Do you intend to run for DEL/ALT or PCP? (Leave blank if you don't wish to be DEL/ALT or PCP)
If CHECKED - I want to run for DELEGATE or ALTERNATE to County and/or State
I intend to run for Precinct Committee Person (PCP)
  
Would you like to help at the Caucus?
Volunteer
Name, Address, Phone & email
Last Name
First Name
Nickname (for Badge)
Address
City
Zip
Phone Home
Phone Cell
Email
Required fields due to State requirements
Employer
Occupation
Understand Costs
Understand I must Attend
 

Costs are under review for CD2, SD23, HD33, JD17 - you'll be notified if they change.  
There are costs to be paid IF you are elected to DEL or ALT.

They are (in addition to transportation and lodging):

 $

Role

15      Delegate to County Assembly
15 Alternate to County Assembly
70 Delegate to State Assembly
60 Alternate to State Assembly
  5 Delegate to CD2, SD23, HD33, JD17
  5 Alternate to CD2, SD23, HD33, JD17
60 Guest to State Convention
15 Student under 16 to State Convention
  Payment is CASH or CHECK only.

Note: Money should be submitted on the night of the County Assembly but not later than March 7, 2018.

               
Broomfield Republicans 2018 Caucus - Pre Registration Form
Do you intend to run for DEL/ALT or PCP? (Leave blank if you don't wish to be DEL/ALT or PCP)
If CHECKED - I want to run for DELEGATE or ALTERNATE to County and/or State {WANT_TO_BE_DEL}{DBID} {VOTER_ID} {SOURCE} {SUBMIT_DATE}
I intend to run for Precinct Committee Person (PCP) {WANT_TO_BE_PCP}
  
Would you like to help at the Caucus?
Volunteer {VOLUNTEER}
Name, Address, Phone & email
Last Name {LAST_NAME}
First Name {FIRST_NAME}
Nickname (for Badge) {NICKNAME}
Address {ADDRESS}
City {CITY}
Zip {ZIP}
Phone Home {PHONE_HOME}
Phone Cell {PHONE_CELL}
Email {EMAIL}
Required fields due to State requirements
Employer {EMPLOYER}
Occupation {OCCUPATION}
Understand Costs {UNDERSTAND_COSTS}
Understand I must Attend {UNDERSTAND_ATTEND}
  {_UNBOUND_STATICTEXT_1}