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Request to Join Caucus
The DPS 109 Caucus is looking for new members. If you are interested in joining the 2022-2023 Caucus, please fill out the form below. More about the Caucus and the requirements for becoming a member can be found on our website at
www.dps109caucus.org
. Be sure to hit the submit button at the bottom of the questionnaire to register your reply. Thank YOU!
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First name:
*
Your answer
Last name
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Your answer
Home address:
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Your answer
Telephone number:
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Your answer
Email address:
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Your answer
Do you currently live within the boundaries of District 109?
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Yes
No
Have you lived within the boundaries of District 109 since February 2021?
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Yes
No
Are you, or any member of your immediate family, an employee of District 109?
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Yes
No
Are you, or any member of your immediate family, a member of the 109 Board of Education?
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Yes
No
Are you planning on running as a candidate for the 109 Board of Education?
Yes
No
Maybe
Clear selection
If you have children attending DPS 109 schools, please indicate which schools from the list below.
Check all that apply.
Kipling
South Park
Walden
Wilmot
Caruso
Shepard
Self-Funding
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The Caucus is now a self-funding organization. At the beginning of the Caucus, we will ask our members to contribute voluntarily $10 to $20 each toward the costs of running the Caucus, if she, he, or they are financially able.
I understand that the Caucus is self-funding through voluntary member contributions.
Required
Please include any additional comments or questions you might have here.
Your answer
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