DeKalb County Delegate/Alternate Application

This application is to become a Delegate or Alternate to the 4th District Convention. You may apply separately for either. Should a Delegate not be able to attend the convention, an alternate will be nominated to replace them.

In order to be a Delegate with Voting rights you must:

Be a Registered Voter. We require you to enter your Date of Birth in the application so that your voter status can be verified.
You must have paid your fee to attend the convention.

DeKalb Delegate Registration

First Name

Last Name

Address

City

Zip

Phone Number

Email Address

Date of Birth.
(Required to verify voter status.)

I wish to be nominated as:

A Delegate

An Alternate

Voter Registration Confirmation

I am a registered voter

Radio Buttons

Option 1

Option 2

If you are human, leave this field blank.

The 4th District Republican Party

A Diverse Group of Citizens

DeKalb County Delegate/Alternate Application