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Potential Candidates

This form is to be used by potential candidates for political office. Please fill out all the information and we will contact you at our earliest convenience.

Name
Address
City, State, Zip
Phone
Fax
Website
Email
Office Sought
State/District
Primary Date
General Date
Have you ever run for office before?
Yes No
If Yes, please explain.
Political Affiliation
Are you an atheist or theist?
(This is strictly for research purposes. Your answer will remain confidential.)
Do you support the complete separation of religion and government?
Yes No
Would you do so if elected to office?
Yes No
Do you support full civil rights for non-religious Americans like atheists and humanists?
Yes No
Would you do so if elected to office?
Yes No
How did you hear about EnlightenTheVote?


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