Submission Form: The No Fossil Fuel Money Pledge
The Pledge: “I pledge not to take contributions over $200 from oil, gas, and coal industry executives, lobbyists, and PACs and instead prioritize the health of our families, climate, and democracy over fossil fuel industry profits.”
Taking the pledge means that a candidate’s campaign will adopt a policy to not knowingly accept any contributions over $200 from the PACs, lobbyists, or SEC-named executives of fossil fuel companies — companies whose primary business is the extraction, processing, distribution, or sale of oil, gas, or coal. Please read this list of Frequently Asked Questions about the No Fossil Fuel Money pledge if you have any questions about what it entails:
http://nofossilfuelmoney.org/FAQ
.
To take the No Fossil Fuel Money Pledge:
1. Take a photo or video of yourself signing the pledge (printable copy:
https://goo.gl/y6mzsu
) OR create a graphic that includes your name, office, and the full text of the pledge.
2. Post the photo, video, or graphic on your social media accounts and/or website with the hashtag #NoFossilFuelMoney OR email the verification to
pledge@nofossilfuelmoney.org
.
3. Fill out this form to notify the No Fossil Fuel Money Coalition that you have signed the pledge.
Examples of graphics:
https://www.pinterest.com/climatebrad/nofossilfuelmoney-pledge-takers/
Please visit the No Fossil Fuel Money website for more information about the pledge:
http://nofossilfuelmoney.org/
If you have any additional questions, please email
pledge@nofossilfuelmoney.org
.
* Required
Politician Name
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Your answer
Office / Office Sought
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Your answer
Party Affiliation (if any)
Your answer
Current Office (if any)
Your answer
Next Primary Date
Your answer
Next General Election Date
Your answer
Contact Information
Staff Contact: Name & Title
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Your answer
Staff Contact: Email Address
*
Your answer
Staff Contact: Phone Number
Your answer
Campaign Facebook Page URL
Your answer
Campaign Twitter URL
Your answer
Campaign Website URL
Your answer
***Pledge Verification***
*
To verify that the politician has signed the No Fossil Fuel Money pledge, please include a link that features the pledge language on an official social media account or website OR email a photo of the politician signing a copy of the pledge to
pledge@nofossilfuelmoney.org
. A printable version of the pledge is available here to physically sign:
https://goo.gl/y6mzsu
. NOTE: Simply answering "yes" or writing your name in this box is not enough to be considered a signer, as a separate, independent verification is needed (because we have no way to know who is filling out this form).
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