Endorsement Request Form
Please complete this endorsement request form as the first step for endorsement by Elect Black Women PAC. Please complete all sections of the questionnaire. If you have any questions, please contact us at Info@electblackwomenpac.com.

Any candidate who receives an Elect Black Women PAC endorsement must agree, win or lose, to stay connected to our community. We know it takes time to elevate our women. Candidates sometimes have to run a few times before they win - 100% of our endorsed candidates will run for office again within 2-4 years with our support, work on another campaign as an operative, or pursue additional leadership roles in their community as an advocate helping to train, support, and Elect Black Women.

Endorsements will be processed every 4-6 weeks until November 8, 2022. Applications received by December 30, 2021, at midnight ET, will be considered/publicly announced as part of the January 13, 2022 endorsement round.

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Email *
Candidate Name *
Candidate Phone Number *
Campaign Address *
Campaign Phone Number: *
Campaign Email Address: *
Campaign Website: *
Candidate Biography *
What office are you running for? *
What type of position are you running for? *
District Number (if applicable)
Party Affiliation on the Ballot (If your race is nonpartisan, please let us know.) *
Candidate Political Registration/Affiliation: *
Candidate race and ethnicity *
Rural or Urban *
Treasurer Name and contact info *
Campaign Manager and contact info *
Total Budget? *
Total Cash on Hand *
Money raised to date overall for the campaign? *
How do you plan to raise money? Call time, email, PACS, etc. *
Spending Priorities: *
List of other endorsements *
Civic Participation and Community Service *
Are you a challenger, incumbent, or is this an open seat? *
Are you a first time candidate? *
What are the issues that your campaign platform focuses on?
Who else is running in your election? Please list the names of all of your competitors and their party affiliation (if this is a partisan race). *
What do you feel are the greatest challenges you will need to overcome to win your election? *
Where is your campaign located? (City, County) *
Where is your campaign located? (State) *
When is the Primary (Day/Month/Year)? Please also include any early voting dates and vote by mail dates for your Primary Election Day.
When is the General Election (Day/Month/Year)? Please also include any early voting dates and vote by mail dates for your General Election Day.
What is the maximum contribution your campaign can receive from a PAC (what is the contribution limit)?
Is there any reason you would decline an Elect Black Women PAC endorsement? For example, you are in a conservative district, concerns about race/identity politics, attacks from other groups, etc. Answering this question honestly will not preclude you from being endorsed, but will help us understand the dynamics of your community. *
Please note, our endorsement condition is that our women want to be a part of a broader political community of black women in electoral politics. We encourage our endorsed candidates, win or lose, to stay connected to our community. Candidates sometimes have to run a few times before they win, so having something “next” is powerful. That something next is ensuring that 100% of Elect Black Women PAC endorsed candidates run for office again within 2-4 years, work on another campaign as an operative, or pursue additional leadership roles in their community as an advocate for Elect Black Women. *
A copy of your responses will be emailed to the address you provided.
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