NEW YORK STATE YOUNG DEMOCRATS

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2007 YDA National Convention - New York Delegate Application
Want to be Convention Delegate? To be considered for a Delegate or Alternate Delegate position you must complete the form below by Saturday June 23, 2007

Your Contact Info	* = required fields
Name *
Address *
City *	State * Zip *
Phone Number
Cellphone while in Dallas
Permanent E-Mail *
Date of Birth *	ex: 01/01/80
Employer (if applicable):
Work Title:
School Currently Attending (if applicable):
Are you a paid member of a chapter?	Yes No
If so, what county?

Please Note: New York Delegates to the 2007 Young Democrats of America National
Convention are responsible for representing the New York State Young Democrats by
voting in general sessions, including the elections for new national officers. You will also
be asked to attend trainings, receptions, convention committee and caucus meetings
during the four-day conference (July 18-July 21, 2007).

YDA has established diversity goals for each state. To assist us in reaching our goals, please let us know if you are or identify as (please select all that may apply):

African American/Afro-Caribbean
Hispanic/Latino
Asian American/ Pacific Islander
Disabled
GLBT
Female
Please note: This information is for internal purposes only and will not be released.

What days do you plan on being in Dallas?

ex: 7/18 - 7/22

Hotel Information.

Please pick one of the options that best describes your lodging situation.

I need assistance with hotel information

I have a hotelroom and need a roommate

I have a hotelroom and don't need a roommate

I don't have a hotelroom and need a roommate

I don't have a hotelroom and don't need a roommate

If you have already booked a hotelroom, which hotel?

ex: Adams Mark

Have someone in mind for a roommate?

Do you have any questions or comments?

In case of an emergency, who should NYSYD leadership contact?

If you are selected to be a delegate or alternate, you will be notified by the Convention Delegation Chair beginning July 1, 2007.