Center For Progressive Leadership - 2011 Local Progressive Candidate Training

To apply to be a part of the Local Progressive Candidate Training Program, please fill out the questions below. The deadline for application submission is April 25, 2012.

You must fill out all information that is marked required:

* - indicates required field

First Name*:
Last Name*:
Primary Email*:
Phone*:
Street*:
Street 2:
City*:
State/Region*:
Zip/Postal Code*:
How did you learn about this program? *:
Please elaborate here*:
Who told you about this program? *:
Please elaborate here*:

The Center for Progressive Leadership is committed to diversity in our programs, including gender, ethnic, racial, economic, geographic, disability, sexual orientation and education. We ask that you complete these optional questions so we can assess our progress in creating a program that matches the full diversity of our states.
Ethnicity:
Other:
Educational Experience:
Gender:
Age:
Language Proficiency (Other than English):
Do you identify as GLBTQ?:
Are you a first generation American?:
Are you a first generation college student?:

Current Employment*:
Current Employment Position*:
Current Volunteer Work And/Or Community Activism You Are Engaged In*:
Which Candidate Program Are You Interested In?*:

I Plan To Run For Office*:
Why Are You Motivated To Run For Office?*:
Please Specify What Office You Are Most Interested In Pursuing As A Candidate*:
Other Office (if needed):
Indicate What District:
Why Are You Interested In This Particular Office? Or - If You Aren't Sure, Tell Us About Which Ones You Are Most Interested*:
Which Of The Following Forms Of Political Activism Have You Engaged In During The Last Year? Please Check All That Apply:	Voted Contacted an elected official Registered voters Contributed money or time to a campaign or cause Worked on an activism or policy campaign Attended a city council or school board meeting Spoke on behalf of myself or a group in the state legislature Spoke on behalf of myself or a group at the U.S. Congress in Washington, D.C. Other (Please specify below):

Have You Ever Run For Office Before?*:
If you answered "Yes":
What Office Did You Run For?:
Did You Win?:
If "Yes," Is Your Term Completed?:
Participants of the Candidate Training Program cannot have already filed, formed an exploratory committee, or raised/spent money on their campaign.

The fee for this training is a $100. The fee helps cover the costs of training, meals and materials.

The Center for Progressive Leadership (CPL) is a nonprofit, nonpartisan 501(c)(3) educational organization.

CPL does not discriminate on the basis of race, ethnicity, gender, sexual orientation or party affiliation.
CPL does not lobby or support, endorse or oppose candidates for office. DHTML JavaScript Menu Courtesy of Milonic.com