Contact MD Alam

Name *

First

Last

Email *

Mobile Number *

Congressional District Number (1-14) *

Are you an elected Precinct Delegate? If yes, Precinct #

Are you an elected official? If so office you are elected

Are you a union leader/member? If yes, union name & #

Are you part of an organization? If so name and position

Do you like to volunteering at MDP? (yes, no, may be)

Will you join MDP?

Will you join MDP Spring Convention?

Do you need a ride to the MDP Convention?

Become a leader: Join MDP County Caucus (1st choice) *

Become a leader: Join MDP County Caucus (2nd choice)

Name of your county (MI: 83 Counties) *

Will you commit to elect MD Alam as MDP Chair? *

Advise, Comment or Message for MDP to improve *