Local Board RPAC Request Form for Local and State Candidates

Local Board RPAC Request Form for Local and State Candidates
Request Date

MonthDayYear
Date
Board
Amount Requested
Your Email Address
Used to send confirmation and follow-up communications.
Name of Candidate

First NameLast Name
Office Sought
City/County
Incumbent?
Party Affiliation
If other, which party?
Main Opponent(s)
Is Opponent Incumbent?
Opponent Party Affiliation
Check Payable To (Campaign Committee Name)
Mailing Address (complete campaign address required for disclosure purposes)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Election

MonthDayYear
Date
Proposed Date of Presentation

MonthDayYear
Date
All Local Board RPAC Requests must be received by GAR at least 14 days before the election listed above unless the Trustee has obtained emergency prior approval from the Chair. RPAC Trustees are located across the state and have commitments outside of GAR, and adequate time to approve and issue RPAC funds is required.

This request is subject to approval by the RPAC Trustees. The candidate must not be notified of any potential RPAC support or dollar amount in advance.
Candidate’s Background (include occupation and offices held)
Why do you consider this candidate to be a REALTOR® Champion? Please provide specific examples.
Candidate’s Relationship to Local Board or Member(s)
Local Board Office Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Local Board President for Approval

First NameLast Name
Local Board President Email
example@example.com
Local Board President Phone
Please enter a valid phone number.Format: (000) 000-0000.
Local Board RPAC Chair for Approval

First NameLast Name
Local Board RPAC Chair Email
example@example.com
Local Board RPAC Chair Phone
Please enter a valid phone number.Format: (000) 000-0000.

Local Board RPAC Request Form for Local and State Candidates

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