Democratic Party * 2020 Delegate Selection Convention

Declaration of Candidacy For Pledged National Convention Delegate

I, ______, hereby certify that I am a registered Montana voter and a Democrat, and declare my candidacy as a pledged delegate to the 2020 Democratic National Convention in support of (check one):

____ ____ Bernie Sanders ____ Elizabeth Warren ____ No Preference as the Democratic nominee for President, and I pledge that I will in good conscience reflect the sentiments of those who elected me. I further pledge that, if elected, I will not publicly support or campaign for any other candidate for President or Vice-President other than the nominees of the Democratic National Convention. I understand that the candidate I support or his/her representative may choose to disallow in writing my candidacy for national delegate.

Signed this ______day of______2020

(Signature)______

Name (please print)______

Address ______

City/Zip______

Phone (cell)______(home)______

E-mail ______

I am filing for the position(s) checked below (more than one may be marked):

Position Qualifications ___ Western District Delegate (No Alternate Position) Resident of Western District

___ Eastern District Delegate (No Alternate Position) Resident of Eastern District

___ Party Leader/Elected Official Delegate (No Alternate Position) Hold any elected office as a Democrat

___ At-Large Delegate*_____At-Large Alternate Resident of Montana

*If I do not win as a Delegate, ____ I DO wish to run as an Alternate (Check one) ____ I DO NOT wish to run as an Alternate

Important Deadlines: Candidates for District-Level, PLEO or At-Large positions must file with the Montana Democratic Party. Fax/Scan this form to Party Headquarters: Fax 406-442-9534/[email protected] and call to confirm (406) 442-9520, or deliver to Party Headquarters at 303 N Ewing St., Helena, MT 59601. District-Level Candidates must file by 5 PM, Friday, June 5th. PLEO Candidates must file within one half hour after the election of District-Level Delegates on June 6th. At-Large Delegates must file within one half hour after the election of the PLEO Delegates on June 6th. ------FOR OFFICE USE ONLY Received by the deadline by ______Approved by the Presidential Representative by ______