Candidate Endorsement Application

Date *

MM

DD

YYYY

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Filing Deadline *

MM

DD

YYYY

Date Term Begins *

MM

DD

YYYY

Affiliation *

Democrat

Independent

Republican

Other

Do you presently hold an elective office? *

Yes

No

Graduation Date

MM

DD

YYYY

Have you received our endorsement for any other political office? *

Yes

No

Occupation Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Occupation Phone

(###)

###

####

Are you willing to protect Ohio against further Right to Work Legislation? *

Yes

No