Preliminary – Personal Info – Temecula Valley Republican Women

Name *

First

Last

Address

City

State

Phone Number

Email *

Office Sought

District

How long have you resided in Riverside County? (years)

Are you a registered Republican?

Yes
No

How long registered? (years)

Current Occupation

Campaign Address

City

State

that you against

Zip

Campaign Website

Committee Title

FPPC#

Staff Contact

Do you now or have you previously held any elected or appointed political office? If yes, please list office and time frame.

Have you previously run for office? If yes, please list office and dates

Please explain why you are running for this office

Please list the top 3 issues your campaign will focus on and why

Have you ever been convicted of a misdemeanor or felony?

Yes
No

Is there anything else in your past record that you have not already disclosed, including but not limited to civil actions against you or your spouse, accused financial or sexual misconduct, or anything else on public record that you feel may serve to harm your campaign or cause Temecula Valley Republican Women to rescind an endorsement?