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Local RPAC Candidate Request Form
CMR's jurisdiction includes Hinds, Madison, Rankin, Yazoo, Holmes, Attala, Leake, Scott, Simpson, and Copiah counties. Candidates seeking funding should complete the candidate request form. All candidates will be invited to interview with the CMR Government Affairs. Recommendations for local candidate endorsement will be submitted to the CMR Board of Directors. Candidates seeking endorsement for state and congressional offices will be submitted for further approval at the appropriate committees at MS Association of REALTORS and the National Association of REALTORS.
Candidate Name
First Name
Last Name
What is your occupation?
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is the elected office you are running for?
What is the status of your candidacy?
Incumbent
Challenger
Open Seat
Campaign Committee Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
List previous campaigns/ elected offices held.
Is candidate a REALTOR?
Yes
No
Affiliate Member
Election Type
Primary
General
Special
Runoff
Date of Election
-
Month
-
Day
Year
Date
Do you have any other endorsements?
Additional Information
Submit
Should be Empty: