Political Candidate Information
Name
*
First Name
Last Name
Office Sought:
*
Incumbent?
*
Yes
No
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Previous Office(s) held and dates:
Current Endorsements
Please list some examples, not all are necessary
Law Enforcement Involvement (Past/Present)
Participation in non-profit/charity/community
Campaign Information
Do you have a campaign manager?
*
Yes
No
If yes, provide name:
Contact number for campaign manager:
Please enter a valid phone number.
Campaign Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you filed for and received your FPPC#?
*
Yes
No
If yes, what is your FPPC#
Campaign Website Address
Twitter
Instagram
Facebook
Other platforms:
What is your campaign platform (topics, values, issues)?
*
Why are you seeking SEBA’s endorsement?
*
Public Employee Pensions
Please explain your stance on public employee pensions and/or retirement options:
*
Public Safety
What will you do to work with SEBA on improving public safety outcomes?
*
Please explain the difference, as you see it, between SEBA and the public safety departments its members work for.
*
What do you see are the challenges SEBA members face?
*
Party Affiliation (for informational purposes only, will not affect any potential endorsement)
*
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to an endorsement, I understand that false or misleading information in my application or interview may result in a rescinded endorsement.
Signature
*
Today's Date
*
-
Month
-
Day
Year
Date
If you have any further questions, please contact our office at (909) 885-6074.
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