MNPL Request Form

Date of endorsement?

Party *

Democrat

Republican

Independent

Thank you for contacting us! If needed, you will hear back within 48-72 hours.

this request is being made by: *

State *

Seat

Senate

House

Seat: *

Candidate Name: *

Incumbent? *

Yes

No

FOR STATE CANDIDATES

about the candidate? *

Sitting Incumbent

challenger

Address of campaign committee: *

If house, what is the congressional district?

Email *

Check here to receive email updates

contribution request amount *

Amount Requested: (Dollar amount required ~ NOT Maximum allowed) *

Email: *

Amount Requested *

Prior Contribution from MNPL *

Yes

No

Prior Contribution from MNPL *

Yes

No

if endorsed, by whom?

Address *

If Approved, address check is to be sent (if different from Campaign address above)

Name: *

Incumbent? *

Yes

No

Seat *

Phone *

After you click submit, this form will then be forwarded to GVP office for approval

State Running In *

State *

State Council

Requested by GVP *

Address of Campaign Committee *

Thank you for submitting a MNPL State form! If there are any questions or concerns Chuck Herod or Tiffany Adams will contact you.

Name

Phone

Check Payable to: (Campaign Committee) *

Party *

Democrat

Republican

Independent

Candidate Name *

Has this candidate been endorsed *

Yes

No

Phone *

Candidate's Name *

District

Requested By: *

MNPL

CONTRIBUTION REQUEST

Date *

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Thank you for submitting a MNPL form! If there are any questions or concerns Neil Douglas will contact you

Email *

Check here to receive email updates

Local

If approved, address check is to be sent (if different from address above)

if approved, where should the check be sent? Please supply name, address, phone number and email below *

After you click submit, this form will then be forwarded to GVP office for approval

*Note* Prior to filling out a form(s) please get approval from your State Council.

CONTRIBUTIONS CONSIDERED IN THE CURRENT ELECTION CYCLE ONLY

FOR FEDERAL CANDIDATES

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