Email * Name * First Name Last Name Preferred Name Age Gender Male Female Non-Binary Two Spirit Intersex Affinity Groups You Identify With (Check All That Apply) * Veteran Teacher Medical Professional Union Member First Responder LGBTQIA2S+ Zip Code * Where Are You In Your Political Journey? * Thinking of Running Currently Running What Level of Government Are Running/Thinking of Running for? * Federal State Municipal District (If Known) What's Your 'Why'? * What are the three (3) most important issues or causes you'd like to champion in your campaign and why? * Which political figures do you most admire and why? * Social Media Handles/Relevant Links * Thank you for your submission! Someone will be in touch soon!
