Become A Labor Candidate

International/Local #*
Name of Potential Labor Candidate/Member*
Public Office Candidate Will Be Seeking*
Date Of Election*
Date Format: MM slash DD slash YYYY
Towns Represented*
Party Affiliation
- Democrat
- Republican
- Unaffiliated
Address of Candidate*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Work Phone
Home Phone
Cell Phone
Fax
Personal Email*
Name of Campaign Bank Account
Offices Previously Held by Candidate
Local Union President/Business Manager
Local Union Phone #