Delegate Candidate Information and Application

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PAID FOR BY THE DEMOCRATIC PARTY OF GEORGIA•PO BOX 20442•ATLANTA, GA 30325•

MIKE BERLON, CHAIR; NIKEMA WILLIAMS, FIRST VICE-CHAIR; RUSSELL EDWARDS, TREASURER;

RJ HADLEY, VICE-CHAIR; MIGUEL CAMACHO, VICE-CHAIR; REP. PEDRO “PETE” MARIN, VICE-CHAIR; LAVERNE GASKINS, SECRETARY

NOT AUTHORIZED BY ANY CANDIDATE OR CANDIDATE’S COMMITTEE • WWW.GEORGIADEMS.ORG • PRINTED IN HOUSE •

Delegate Candidate Information and

Application

Democratic Party of Georgia

Prepared by: Ansley Tuten



PAID FOR BY THE DEMOCRATIC PARTY OF GEORGIA • P.O. BOX 20442 • ATLANTA, GA 30325


RJ HADLEY, VICE-CHAIR; MIGUEL CAMACHO, VICE-CHAIR; REP. PEDRO “PETE” MARIN, VICE-CHAIR; LAVERNE GASKINS, SECRETARYNOT AUTHORIZED BY ANY CANDIDATE OR CANDIDATE’S COMMITTEE•WWW.GEORGIADEMS.ORG

A Message from our Chairman

Thank you for your interest in becoming a Delegate to the

Democratic National Convention! On September 3, 2012,

Democrats from across the nation will gather in Charlotte, NC

to celebrate the Party’s nomination of President Barack

Obama for re-election to our nation’s highest office. This

convention will culminate on September 6th

, when President

Obama addresses the Delegates and accepts our Party’s

nomination for President of the United States.

The state of Georgia will send 124 Delegates and 9 alternates to Charlotte. This manual

is meant to outline the process by which a registered voter may become one of these

Delegates. The process for becoming a Delegate is highly competitive and democratsfrom all over Georgia will be competing for those positions. The Democratic National

Committee and the Democratic Party of Georgia are dedicated to ensuring that

everyone who is qualified to run has that opportunity. We are also committed to

making sure that Georgia’s delegation adequately represents our State’s diverse

population.

We are eager to share with you the process of becoming a Delegate and stand ready to

answer any and all questions you may have. The process can seem a bit complicated,

but we are here to help make it as straightforward as possible. If you have anyquestions, please contact your Congressional District Chair or Democratic Party of

Georgia County Affairs Director, Ansley Tuten.

Democratically yours,

Mike Berlon

Chairman of the Democratic Party of Georgia






The Georgia Delegation-How Many Delegates Do We Have?

Georgia will elect 124 Delegates and 9 alternates to represent our State at the

Democratic National Convention. 72 of these Delegates (about 75% of the total

delegation) will be elected at the District-Level Delegate Caucuses to be held in each

Congressional District across the state on Saturday April 21, 2012. In addition to theseDelegates, 24 At-large Delegates, plus 9 additional Alternates will be elected by our

State Committee members at a later date in May.

14 Delegate spots are reserved for those considered Party Leaders and Elected Officials,

commonly referred to as “PLEOs”. These Delegates will be elected at a separate

election that will held by our by our State Committee Members in May. While only

current and former elected officials may run to be a PLEO Delegate, anyone may run to

be an At-large or alternate Delegate, including candidates who ran unsuccessfully on the

district-level.

Gender Equity and Priority of Consideration

The DNC mandates that each delegation brought to the Democratic National

Convention contain an equal number of men and women. In this spirit, district-level

Delegate caucuses must elect a pre-determined number of men and women in each

district. The break-down of Delegates to be elected in each district is as follows:

District # of male

Delegates

# of female

Delegates

Total # of

Delegates

1 3 2 5

2 2 3 5

3 3 3 6

4 4 3 7

5 3 4 7

6 3 2 5

7 3 3 6

8 2 3 5

9 2 2 4

10 3 2 5

11 2 3 5

12 3 2 5

13 3 4 7

TOTAL 36 36 72






Additionally, the DPG is committed to electing a delegation that is representative of the

state of Georgia. The DPG has set its diversity goals based on the census data from the

population of Georgia. These goals are as followed:

African

Americans

Hispanic

Americans

Native

Americans

Asian

Americansand

Pacific

Islanders

LGBT

Americans

People

withDisabilities

Seniors

65+

Youth

Unde30

% of

Democratic

electorate

62.8% 1.6% undetermined 1.2% 5.9% 11.9% 15.7% 17.8%

Numeric

Goals for

Delegation

72 2 1 1 7 15 19 22

These are not mandates; they are goals which we will make every effort to achieve. In

the election of At-large and alternate Delegates, priority of consideration shall be given

to candidates who belong to these groups.

Financial Obligations of Becoming a Member of the Georgia Delegation

The cost of attending the 2012 Democratic National Convention in Charlotte as a

Delegate will range from $2000-$4000. Delegates will be responsible for all costsassociated with attending convention which include, but are not limited to: hotel

accommodations, travel and food. The costs associated with convention reduce if a

Delegate chooses to share a room with another Delegate. Delegates may also fundraise

independently to help cover the cost of convention. Under no circumstances will the

National or State Democratic Parties be held responsible for any costs associated with

individual Delegates. Potential Delegate candidates must sign a waiver acknowledging

this statement before they are eligible to run for a Delegate spot.

Qualifying to be a Delegate Candidate

Anyone wishing to run to be a Delegate must meet the following criteria:

Be a registered voter in the district in which they intend to run

Fill out the security clearance, candidacy application, statement of intent, and the

candidate party forms located on the Georgia Democrats website,

www.georgiadems.org, or at the conclusion of this manual.

http://www.georgiadems.org/








These forms must be filled out and sent to the DPG offices no later than March 22,

2012. Forms may be submitted:

Electronically, by emailing signed copies of these forms to

[email protected]

By fax, to the attention of Mike Berlon at 877-744-9438

By mail, to the attention of Mike Berlon at PO BOX 20442, Atlanta, GA 30325.

Mailed candidate affidavits must be postmarked by March 22, 2012

By hand-delivery, to the Democratic Party of Georgia Headquarters, located at

763 Trabert Ave. Atlanta, GA 30318.

Presidential Right of Refusal

After all of our candidates have submitted their application, security clearance,

statement of intent, and candidate party declaration, each candidate will be submittedto the presidential campaign to undergo a vetting process. If a candidate is stricken from

the list by a presidential campaign, they will be unable to declare candidacy for a district

level, At-large, or alternate Delegate position. Elected Delegates are also subject to a

vetting process by the presidential campaign, and failure to vet will result in a Delegate

not being allowed to be seated with the delegation.

How is the Georgia Delegation Elected?

There are two methods by which a registered voter may be elected to serve as aDelegate to the Democratic National Convention. Delegates are elected by their

congressional districts in district-level caucuses, or can be elected by the Democratic

Party of Georgia’s State Committee.

District-Level Delegate Caucuses

Each of the Democratic Party of Georgia’s Congressional District Chairs has selected a

central location in their congressional district to serve as a site for the District-Level

Delegate Caucuses, to be held Saturday April 21, 2012 at 8am. Voting will begin

promptly at 12pm and no other electors will be permitted to cast ballots if they have not

registered by the beginning of voting.

The contact information for our 13 Congressional District Chairs can be found here:

mailto:[email protected]








Congressional

District Chair Contact Information

1 Jeana Brown [email protected]

912-294-3167

2 Kattie Kendrick [email protected]

478-825-2985

3 George Johnson [email protected]

678-358-4655

4 Acting Chair: Rep. Billy Mitchell [email protected]

770-465-8800

5 Catherine Smith [email protected]

678-596-1845

6 Ben Myers [email protected]

770-570-8981

7 Steve Reily [email protected]

404-277-4784

8 Stephanie Woods-Miller [email protected]

9 David Robinson [email protected]

770-893-9134

10 Patsy Harris [email protected]

706-342-1011

11 Don Wilson (Interim) [email protected]

678-334-8050

12 Liz Johnson [email protected]

912-541-1237

13 Melissa Prescott-Crawford [email protected]

678-462-8270

Method of Election

Registration for the District-level Delegate caucuses will begin at 8 am on Saturday April

21, 2012. Anyone registered to vote in the congressional district in which they intend to

caucus may cast a vote for Delegate candidates. Registration will close at exactly 12 pm

and no other electors will be permitted to cast votes for Delegate candidates. Anyone in

line, but has not completed the registration process by 12pm will be allowed to register

and cast a vote for their preferred Delegate candidates. Candidates are allowed two

minutes to address the audience, and are not permitted to have a nominating or

seconding speech.

Ballots will be distributed and voters may vote for a number of candidates equal to the

number of Delegates to be elected from the district. For example, the first congressional











































district has been allotted three male and two female Delegates, so voters may select up

to three male and two female candidates.

Anyone who is registered to vote, is willing to sign a statement of support for the

Democratic Party, and resides in the district in which they are intending to vote is

permitted to cast a ballot at the District-Level Delegate Caucus. Each candidate mayencourage their supporters to attend the caucus and cast a vote for them.

The highest vote-getter, regardless of gender, is seated first. The next highest vote

getter of the opposite gender is seated second, and the seating alternates by gender

until all of the Delegate seats have been filled. Due to gender equity requirements, this

method of seating Delegates may result in a candidate being chosen to be a member of

the Georgia Delegation who received fewer votes than a candidate of the opposite

gender.

At-large and Alternate Delegates

Individuals wishing to run for Delegate at large, including unsuccessful Delegate

candidates at the district-level must submit the appropriate candidate forms outlined on

the “Georgia Delegate Candidate Check-list” of this manual by April 26, 2012.

Unsuccessful Delegate candidates at the district-level must re-submit these forms to be

considered a candidate for an At-large Delegate spot. Delegates will be elected by a

special meeting of the Democratic Party of Georgia’s State Committee to be held in

Macon, GA on May 19, 2012. Only State Committee Members will be allowed to vote for

these Delegate candidates. At-large and alternate Delegates are also subject to review

by presidential campaigns.






Georgia Delegate Candidate Check-list

To complete the Georgia Delegate Application Process, the mandatory forms

listed below must be submitted by the appropriate District-level (March 22, 2012)

or At-large (April 26, 2012) application deadline.

_____ Georgia Delegate Application-Security Clearance

_____ Georgia Delegate Application- 2012 National Convention

_____ Georgia Delegate Application-Statement of Intent

_____ Georgia Delegate Application-Candidate Party Declaration

Please submit these forms to PO Box 20442, Atlanta, GA 30325 ATTN: Delegate Selection, by email to

[email protected] or by fax to 877-744-9438

_____________________________________________________________________________________________

Dates to Remember:

Varies Georgia Delegate Training Workshops by Congressional District

March 6, 2012 Presidential Preference Primary

March 22, 2012 District-level Delegate Candidate Application Deadline

April 14, 2012 DPG receives list of approved Delegate candidates

April 21, 2012 District-level Delegate Caucuses

April 26, 2012 At-large Delegate Candidate Application Deadline

May 12, 2012 DPG receives list of approved Delegate candidates

May 19, 2012 At-large Delegate election- Macon, GA

Please contact your Congressional District Chair or DPG County Affairs Director with any questions that you may

have.









Georgia Delegate Application

Security Clearance

Please complete this form to obtain a 2012 Democratic National Convention security clearance.

Additional forms may be required by the State Democratic Party or the DNC

Personal Information

Name as it appears on official documents

____________________________________________________________

Complete Address: __________________________________________

__________________________________________

__________________________________________

Phone Number: __________________________________________

Alternate Phone Number: ______________________________________

Email Address: __________________________________________

Congressional District: _________________________________________

Please Check all that Apply:

Gender: ____Male ____Female

Ethnicity: ___African American ____Asian-Pacific___Caucasian___Latino___Native AmericanAge: ___Youth (18-29)___Middle Aged (30-60)___Senior Citizen (60 and above)

Orientation: ___Lesbian, Gay, Bisexual, Transgender ___Heterosexual

Disability: ___Yes, please describe: _________________________________

Social Security Number: _____________________ Date of Birth: __________________

Party Leadership or Elected Positions:______________________________________________

Preferred Presidential Candidate:_________________________________________________

Marital Status: _______Single ______Married ______Divorced

Name of Spouse or Significant Other: ______________________________

Names of Children: _______________________________________________






Georgia Delegate Application

2012 National Convention

Emergency Information

Emergency Contact: _____________________________________

Emergency Contact Address: _____________________________________

_____________________________________ _____________________________________

Any Known Allergies: _____________________________________

Illnesses or Special Concerns: _____________________________________

_____________________________________

Any other information: _____________________________________

Educational Information

Name of School(s): _______________________________________

Programs or Degrees: _______________________________________

Occupational Information:

Employer’s Name: _________________________________________

Employer’s Address: _________________________________________

_________________________________________

_________________________________________

Occupation: _________________________________________

Hobbies and Interest: ______________________________________________________________________________

______________________________________________________________________________

The information provided in this document is accurate and complete to the best of my

knowledge. I hereby authorize the Democratic Party of Georgia, The Democratic National

Committee, and other parties affiliated with the planning of the 2012 Democratic National

Convention full and complete permission to complete a background check using the above

information.

________________________ ______________________ ____/_____/____

Print Complete Name Signature Date






Georgia Delegate

Statement of Intent

Please complete this Georgia Statement of Intent (1) to officially declare your Presidential

Candidate of choice and (2) to acknowledge your financial responsibilities if selected as a

Georgia Delegate.

Complete Name: ____________________________________________

Occupation: ____________________________________________

Congressional District: ___________________________________________

Complete Address: ____________________________________________

____________________________________________

____________________________________________

Phone Number: ____________________________________________

Alternative Phone Number: _______________________________________

Email Address: ____________________________________________

Please Check all that Apply:

Gender: ____Male ____Female

Ethnicity: ___African American ____Asian-Pacific___Caucasian___Latino___Native American

Age: ___Youth (18-29)___Middle Aged (30-60)___Senior Citizen (60 and above)

Orientation: ___Lesbian, Gay, Bisexual, Transgender ___Heterosexual

Disability: ___Yes, please describe: _________________________________

Party Leadership or Elected Positions: ______________________________________________

Preferred Presidential Candidate: __________________________________________________

Receipt of this Statement of Intent certifies that I, _____________________ officially intend

to seek election as a Georgia Delegate to the 2012 Democratic National Convention.

X________ I understand that the Presidential Candidates have the right to approve or

disapprove of my candidacy.

X________ I understand that if elected, I am financially responsible for all Delegate related

expenses, including: travel, lodging, meals, registration fees, etc.

I hereby declare my candidacy as a Georgia Delegate to the 2012 Democratic National

Convention.

___________________ ______________________ ____/_____/____






RJ HADLEY VICE CHAIR MIGUEL CAMACHO VICE CHAIR REP PEDRO “PETE” MARIN VICE CHAIR LAVERNE GASKINS SECRETARY

Georgia Delegate

Candidates Party Declaration

Please complete this Candidates Party Declaration to officially declare your Party affiliation.

Complete Name: __________________________________________________

Congressional District: _________________________________________________

Complete Address: __________________________________________________

__________________________________________________

__________________________________________________

Phone Number: __________________________________________________

Email Address: __________________________________________________

Receipt of this Party Declaration Form certifies that I, ___________________________, am

resident and registered to vote in the _______ Congressional District, located in

______________ County, GA.

My initials signify and proclaim that the below statements are true and accurate:

______ I believe in the goals of the Democratic Party of Georgia

______ I am not a member of any other political party or body (as defined in the

Georgia election code)

______ I am not affiliated with any political group whose ideas, goals, and methods

are incompatible with that of the Democratic Party of Georgia (as identified by

the Executive Committee of the Democratic Party of Georgia).

______ If it is found that I have submitted this Party Declaration under false

pretenses, I am subject to immediate disqualification as a Georgia Delegate or

Alternate Delegate.

I meet all qualifications and hereby declare my candidacy as a Georgia Delegate to the 2012

Democratic National Convention.

________________________ ______________________ ____/_____/____


Delegate Candidate Information and Application

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