TG Town candidate profile

Name *
Prefix
First *
Last *
Suffix
Date of birth *

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City/town of birth *
Phone Number, in case we have any questions. This will not be published. *

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Email address. This will not be published.
Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Party affiliation *
Office sought *
Current office held, if any
Prior public office held, if any
Employment history *
Educational background *
Clubs, Organizations, Honors, Achievements *
Candidate statement *
Head-and-shoulders photo of yourself. Please upload here.
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