Political Resource Order Form

Political Resource Order Form
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Name of Organization Requesting List*
Principal Officer*
What is this request for?*

Labor WalkLabelsRobocallCountsPhone BankMailingFlyers
Please list the quantity of flyers and color of paper required

Race Specifics
Candidate Name OR Issue*
Please be specific! If you are not specific, the request will not be approved.
Candidate Party Affiliation

DemocratRepublicanIndependentWorking FamiliesConservativeGreenOther
Please list race(s) AND geography involved
Example: CD 1 and AD 1 overlap in Albany County excluding EDs 1, 2, 3, 4, 5, 9, 10
Please specify target universe. How many homes will you be visiting or phone calls will you be making?*
If this request is for a labor walk, where are you launching from?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Action

MonthDayYear
Date
Time of Action

Hour Minutes

AM/PM Option

Delivery

Where is the list being delivered? If Mailhouse or Robocall, please include company name, contact, email address and phone number.
How do you want this list delivered?*

EmailMail
Contact Email (leave blank if you are the contact)
example@example.com
What name should go on the package?

First NameLast Name
Contact Phone Number (for mail or robo)
Please enter a valid phone number.
What address should we send the list to?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has this race been submitted FORMALLY through the approval process for unions? Unsure? Check NO!*

YesNo
If NO please continue filling out form with the understanding that exempted unions and their membership will not be included in the product until or unless approved.
Is there any other important information we should know about this request? Are there any unions opposed? Any special conditions?
Should be Empty:

Race Specifics