BWOPA LOCAL CHAPTER
PAC ENDORSEMENT REQUEST APPLICATION
Endorsement Request
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 do you want to run for office and what are your goals if you win? What are the biggest challenges facing your city?
Your answer
Do you believe health care is a right or a privilege? Should we have a social contract for healthcare the way we do for education?
Your answer
Do you support equal rights for women?
Your answer
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 increased access to childcare and other dependent care programs funded from all available sources?
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
Do you support local increases to the minimum wage? Would you support a prevailing wage ordinance?
Your answer
Are you a supporter of Affordable Housing?
Your answer
How much housing to build is a major issue of debate in our communities:
List your top 3 platform issues and why they are important to BWOPA:
Your answer
Who recommended you seek BWOPA-PAC's endorsement?
Your answer
Please share your brief bio:
Your answer
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms
Google Forms