Submission Form: The No Fossil Fuel Money Pledge
The Pledge: I pledge to not take contributions from the oil, gas, and coal industry 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 or executives of fossil fuel companies — companies whose primary business is the extraction, processing, distribution, or sale of oil, gas, or coal. We will provide a list of these companies upon request.

To take the No Fossil Fuel Money Pledge:

1. Take a photo of yourself signing the pledge (printable copy: https://goo.gl/y6mzsu) or create a shareable graphic that includes your name, seat you’re running for, and the text of the pledge.
2. Post the photo or graphic on your website or social media accounts with the hashtag #nofossilfuelmoney
3. Fill out this form to notify the No Fossil Fuel Money Coalition.

Examples of graphics: https://www.pinterest.com/climatebrad/nofossilfuelmoney-pledge-takers/

If you have any questions, please send an email to pledge@nofossilfuelmoney.org.

You can find more information about the pledge here: http://nofossilfuelmoney.org/

Candidate Name
Your answer
Office Sought
Your answer
Candidate Party Affiliation
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Current Office Held (if any)
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Primary Date (if any)
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General Election Date
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Contact Information
Campaign Contact: Name & Title
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Campaign Contact: Email Address
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Campaign Contact: Phone Number
Your answer
Campaign Facebook Account URL
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Campaign Twitter Account
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Campaign Website URL
Your answer
Do we have permission to use a headshot or similar image from your campaign website on our website? To be consider a pledge signer, the answer must be "Yes."
***Pledge Verification***
To verify that the candidate or elected official has signed the no fossil fuel pledge, include a link that features the pledge language on an official campaign website or social media account. One easy way to do this is to print out the following pledge and tweet a picture of you physically signing it: https://goo.gl/XiKbu2. You may also email a photo of the candidate or elected official signing copy of the pledge to pledge@nofossilfuelmoney.org.
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