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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your contact info?

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* 4. What office are you interested in running for someday?

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* 5. Why are you interested in running for office?

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* 6. Have you run for office before?

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* 7. If yes, what office did you run for, what year did you run, and were you successful? Tell us about your experience.

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