Candidate Interest Form

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Candidate Interest Form

This form will collect information on potential candidates.

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* Indicates required question

Email *

Your email

Full legal name *

Your answer

Chemung County Democratic Committee

Legal Address street, city, zip code) *

Your answer

Place of birth (city, state, county if other than the US) *

Your answer

Phone number(s) *

Your answer

Facebook Account name *

Your answer

Twitter Account name *

Your answer

Other social media accounts (Tick Tock, Instagram, Snapchat, etc.) *

Your answer

Have you ever run for office? *

yes

no

If you have run for office, what did you run for? *

Your answer

What office are you interested in running for and why? *

Your answer

Submit

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