Political Resource Request Form

Political Resource Request Form
Your Name*

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

Labor WalkLabelsCountsPhone BankMailingFlyers
What is this request for?**

Labor WalkLabelsRobocallCountsPhone BankMailingFlyers
How many do you need?*
Race Specifics
Candidate Name OR Issue*
Please be specific! If you are not specific, the request will not be approved.
Candidate Party Affiliation

DemocratRepublicanWorking FamiliesConservativeGreen
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
How many door packets do you need?*
What is your target universe?
If this request is for a labor walk or in-person phone bank, where should volunteers report?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you need the NYS AFL-CIO to create an event for your action in Mobilize?*

YesNo
Mobilize event link*
Date of Action

MonthDayYear
Date
Start Time of Action

Hour Minutes

AM/PM Option
End Time of Action

Hour Minutes

AM/PM Option
Resource Delivery Information

If you are requesting a list for a mailhouse, please provide the company name, contact, email address and phone number.
Recipient Name*

First NameLast Name
Recipient Email*
example@example.com
Company Name (if recipient is a mailhouse)
Contact Phone Number (if recipient is a mailhouse)
Please enter a valid phone number.
How do you want this list delivered?*

EmailMail
Delivery Address (if applicable)

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:

Political Resource Request Form

Race Specifics

Resource Delivery Information