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HRP Delegate Appointment Request
Nominator Email address
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Email
*
Your email
Email address (of nominee)
*
Your answer
First Name (as listed on your voter registration)
*
Your answer
Last Name (as listed on your voter registration)
*
Your answer
Address (as listed on your voter registration) (Street, City, HI ZIP)
*
Your answer
Primary Phone Number (10 digits)
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Your answer
House District and Precinct (if known) (DD/P)
*
Your answer
Delegate or Alternate (Select One)
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Delegate
Alternate
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Your answer
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