EmailMe Form - Candidate Interest

This form is an interest submission form. To officially file you must fill out an Application for Nomination form (www.lptexas.org/candidate-forms) by the deadline (Dec 11). *
I understand and intend to file an Application for Nomination to officially seek nomination
I am interested and I would like further information before filing
Name *
First Middle Last Suffix
Which county do you live in? *
Email *
Mobile Phone
### - ### - ####
Home Phone
### - ### - ####
Registered Voter Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Best Time To Call
HH : MM AM/PM
Preferred Contact
Email
Phone
Run for Office Information
The following information will help us understand more about your desire to run as a Libertarian Candidate.
What office(s) are you interested in running for
US Congress
State Judicial
Statewide (Gov, Lt. Gov, RR, etc)
State Senate
State House
Local (Sherif, County Judge, County Commissioner, etc)
What type of campaign are you interested in running?
Choice - Basics / Give people options
Change - Responsive / Education
Challenge - Want to fight for a win
Specific Office Interest
If you already know specifically for which office you want to run and when please let us know.
Voter Registration (VUID) *
Voter ID from Voter Registration Card
Date of Birth *
MM / DD / YYYY

Status

	Yes	No	Unsure
Did you vote in the primary of another party this election cycle?
Are you affiliated (a voting member) with LP Texas?
Have you donated to LP Texas in the last year?

Occupation
Weekly Commitment
How many hours, each week, can you commit to your campaign.
How long have you lived in Texas? *
How long have you lived in your county? *
Do you agree with the
LP Texas Platform? *
Yes
No
Have not read / Other
lptexas.org/state-platform
If no, please provide detail.
Please let us know why you would like to run for office as a Libertarian.
Do you agree with the statement: "I do not believe in or advocate the initiation of force as a means of achieving political or social goals."?
Yes
No
Unsure