BWOPA LOCAL CHAPTER
PAC ENDORSEMENT REQUEST APPLICATION
Endorsement Request
Early Endorsement
Regular Endorsement
Name
Your answer
Office Sought
Your answer
Address
Your answer
Phone
Your answer
Email
Your answer
Website
Your answer
Occupation
Your answer
Campaign Committee Name
Your answer
FPPC#
Your answer
Treasurer
Your answer
Phone
Your answer
Fundraising Goals
Your answer
Chair/Consultant
Your answer
Campaign Contribution Limits
Your answer
Why predicated you to run for office and what are your goals, if you win? What are the biggest challenges facing your city?
Your answer
List your top 3 platform issues and why you believe these are important to BWOPA:
Your answer
Do you support equal rights for women?
Yes
No
Other:
Do you support the passage of the Criminal Reform Act? Would you support programs and legislation aimed at rehabilitating offenders, facilitating a successful transition from prison to community, and reducing recidivism?
Your answer
Do you support legislation to protect equal rights for all individuals regardless of gender, race, age, religion, ethnic origin, disability, sexual orientation or real or perceived gender?
Your answer
What is your position on local increases to the minimum wage? Would you support a prevailing wage ordinance?
Your answer
What is your position on Affordable Housing?
Your answer
Your Election Date
MM
/
DD
/
YYYY
What are your community accomplishments?
Your answer
Who recommended you seek BWOPA-PAC's endorsement?
Your answer
Please share your brief bio:
Your answer
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DD
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