Satellite Caucus Application Applications are due by November 18, 2019. Applications may be delivered to 5661 Fleur Drive, Des Moines, IA 50321 or via email at satellite.caucus@iowademocrats.org Your name: _________________________________________________ Your phone number: _________________________________________ Your email address: __________________________________________ I attest that I am registered to vote as a Democrat in the state of Iowa and that the information provided in this application is true to the best of my knowledge: ___________________________________ (signature or mark of applicant) Proposed Satellite Caucus Site (location) Information State of proposed satellite site: ________________________________ County of proposed satellite site: _______________________________ Site name: __________________________________________________ Site address: ________________________________________________ Site contact name: ___________________________________________ Site contact phone: __________________________________________ Site contact email: ___________________________________________ Satellite Caucus Application Please provide a detailed reason describing the need for this satellite site (use additional pages if needed): PAID FOR BY THE IOWA DEMOCRATIC PARTY Satellite Caucus Application Venue Information Has the owner/manager approved the use of this site? (Please attach documentation of the owner/manager's approval, if available.) Is this location normally open to the general public? If not, please describe who is allowed in this location. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Hours the site is available: ● If this is a public facility, what hours is the caucus site open to the public? ______________________________________________________ ● If this is a closed site, what hours is the caucus site available to you? _______________________________________________________ Is there a designated parking lot, and how many spots are available? ____________________________________________________________ If there is not a designated parking lot, please describe the nearest available parking or provide an explanation why parking is not needed. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ PAID FOR BY THE IOWA DEMOCRATIC PARTY Satellite Caucus Application Number of tables available to use during the caucus: ______________ Number of chairs available to use during the caucus: ______________ Does the venue have Wi-Fi that is available to caucus leaders? ____________________________________________________________ Is there sufficient space for preference groups to form in the caucus room? ____________________________________________________________ Will the venue allow directional signage to be hung on the walls? ● Democratic Party signs? _________________________________ ● Candidate signs? ________________________________________ PAID FOR BY THE IOWA DEMOCRATIC PARTY Satellite Caucus Application ADA Compliance and Functional Accessibility Satellite caucus sites that are approved to be open to the general public must be ADA compliant. Does the building claim to be ADA compliant? ____________________ Are there any stairs from the main building entrance to the caucus room? ____________________________________________________________ Are all hallways and doors at least 36 inches in width? _____________ Are there ADA compliant restrooms in the building? _______________ How many designated accessible parking spots are available? ____________________________________________________________ What is the walking distance from the parking area to the caucus room? ____________________________________________________________ Do any accommodations need to be made to make this location ADA compliant? ____________________________________________________________ Please include diagrams and/or photos of the venue and caucus room: PAID FOR BY THE IOWA DEMOCRATIC PARTY Satellite Caucus Application Caucus Information Satellite Caucus Sites that anticipate 10 or more attendees have a greater likelihood of being approved. Unless this is a request for an accommodation under the ADA in order to be able to participate in the Caucuses; however, all applications will be considered. How many potential caucus-goers would attend this satellite caucus who would not otherwise be able to attend their precinct caucus? ____________________________________________________________ How many people do you estimate will participate in this satellite site? ____________________________________________________________ Time the caucus will occur: (if not 7 pm CT, please explain why) ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ PAID FOR BY THE IOWA DEMOCRATIC PARTY