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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?

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Do you need a ride to the MDP Convention?

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

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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 *