Membership Application – HADC of Broward

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Applicant Information

Our Mission: To empower, educate, inform and engage the community in the democratic process, to enhance the Democratic Party.

Voter's Type:

Member (Voting)
Associate (Non-Voting)

Name *

First

Last

Date of Birth (mm/dd/yyyy) *

Email *

Mobile Phone *

How do you prefer to be contacted? (Select all that apply) *

Email
Phone
Text message
WhatsApp

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Registration County

Precinct

Voter ID

I wish to volunteer in the following committee(s). Check all that apply.

Membership/Onboarding/Welcoming
Political Action Committee
Communications
Candidate Training and Development
Fundraising
Events
Outreach
Voter Registration and Education

Are you a Broward Democratic Pary DEC Member?

Do you consider yourself a leader, an agent of change?

How many hours a month can you volunteer?

3 hours
5 hours

What is an issue you are passionate about?

Economic Empowerment
Community Education
Other

Other (please specify):

HADC & You

This section will help us learn a bit more about your interest in the Haitian American Democratic Club.

How did you hear about us? (Select all that apply) *

From a current or past member
Attended a fundraising event in the community
Search engine results while researching volunteer/community organizations
Website
Social Media
I am HADC alumni
Other

Other (please specify):

Name of the person who referred you

Name and date of event

Which social media profiles?

Facebook
Instagram
LinkedIn
YouTube

Other (please specify)

Preferences

Please share your preferences to help us ensure the best fit.

Why are you interested in joining HADC? (Select all that apply)

Make a Difference in Your Community
Increase Political Awareness & Influence
Support Democratic Candidates
Engage in Voter Registration & Mobilization
To make new friends
Professional skill building and leadership opportunities
Defend Democracy & Civil Rights
Other

Other (please specify):

HADC operates through members volunteering their skills. How are you able to help?

Communications & Social Media
Fundraising & Donor Engagement
Event Planning & Execution
Outreach & Community Service
Canvassing and Phone Banking
Encourage Vote By Mail (VBM)
Maintaining websites
Other

Other (please specify):

Our club meets on the third Thursday of each month at 6:30 AM. Does this work with your schedule? *

Always
Most of the time
Sometimes
Never

Choose Payment Method

Zelle
In Person

1. Scan the QR Code or

2. Click the following link to pay with Zelle https://tinyurl.com/5fw6u6cx

Agreement *

I agree to the terms below.

I understand that if my application is accepted, I will be expected to participate regularly and pay an annual due of $25.00.

Date