Gilmer County Republican Party

Nomination Form
Name (Please Print)___________________________________________________________
Address_______________________________________________________________________
Phone Number___________________________ Email Address_____________________

Being a Delegate to the 9th District Convention and/or the State Convention requires commitment and has
costs associated with it. If you are able to uphold this commitment and are interested in becoming a
delegate, please check the convention you wish to attend and either delegate or alternate (NOTE: All
delegate slots must be filled before any alternates can be selected).
Criteria for being a Delegate/Alternate to the District and/or State Convention(s):
● A Gilmer County resident who is legally registered to vote in Gilmer County
● A Gilmer County resident who believes in the principles of the Republican Party and supports elected
Republican officials and candidates.
● A Gilmer County resident who fully supports the Gilmer County GOP through engagement of
attending meetings, events, fundraisers, etc.

9th District Convention in Dillard, GA, on April 20, 2024

● Delegate
● Alternate
State Convention in Columbus, GA on May 17-18, 2024
● Delegate
● Alternate

Please provide a short paragraph with your political resume on why you would like to represent Gilmer
County.
I attest that I am a Republican and commit to the conservative values of the Republican Party. If elected, I
will uphold the office by supporting the Republican candidates and elected officials when in my elected
capacity.

Signature____________________________________________ Date_____________________

Please submit this completed form and your political resume’ with a short paragraph to the Nominating Committee by
Friday, March 1, 2024 by emailing your information to jackjoy1151@gmail.com.