WinVA 2019 Candidate Training RSVP

Campaign Committee Name:

Campaign Mailing Address:

Campaign Website:

Campaign Social Media Handles

Campaign Email:

What office and district are you running for (Ex: Delegate - 17; Senate - 32)?

Are you running for office in 2019?

Yes

No

Have you officially filed as a candidate?

Yes

No

I have submitted my registration deposit:

Yes

No - (please submit it here)

Do you have any dietary restrictions or allergies?

What size t-shirt do you wear?

S

M

L

XL

2XL

3XL

4XL

5XL

Women's S

Women's M

Women's L

Women's XL

Tell us about yourself! Please include a short biography. We'll share it with our trainers and other candidates. (150 - 200 words)
Some guidelines -- please write it in the third person, keep it under 150 words, and make sure you include where you're from, what you're running for, and if you already hold an elected office! If you need some inspiration, I've included a sample biography below that’s a great start: "Meredith Nakayama is from Virginia and is running for the Virginia House of Delegates. She grew up in Northern Virginia and moved back to the area after graduating from Wellesley with a major in International Relations and a minor in Economics. She currently serves as Chief of Staff to a delegate in the Virginia House of Delegates. In this role, she develops state-level policy while managing staff, media, and the delegate’s scheduling. Meredith’s political roots are in field organizing. She focused on building and organizing communities to turn out progressive voters during a congressional campaign in 2016 cycle. She wants to use the professional skill sets she has developed to fight for progressive legislation and values. Progressives in Virginia have trouble securing wins in down ballot races. Meredith believes that her candidacy can add to the narrative of Democrats taking back control in the Virginia General Assembly.”

Please read and digitally sign our photorelease form:

I understand that photos and/or videos of me will be taken, on or about March 2019, by or for WinVirginia and that these photos and/or videos, including my image, may be used in television and/or radio and/or in any other public communications to be used and/or distributed by WinVirginia as WinVirginia may see fit. I understand that WinVirginia are the sole and exclusive owners of all photos and/or audiovisual recordings made of me and that WinVirginia may edit the photos and/or audiovisual recordings. I hereby grant to WinVirginia the right to make photos and/or audiovisual recordings of me; to use any or all of such recordings in print, electronic, Internet, television, radio, broadcast or any other form of advertising; in promotional, marketing, and/or fundraising materials; and/or in communications, on WinVirginia’s website, in emails, and in any other visual and/or audio works (all such advertising, promotional, marketing, fundraising, emails, websites, communications and any other works being hereinafter referred to as “WinVirginia Communications”); to distribute, reproduce, copy and use the WinVirginia Communications in any manner and by any method, anywhere in the world, for any purpose, in perpetuity, and to grant to any other person or entity the right to distribute, copy, and use the WinVirginia Communications in any manner and by any method, anywhere in the world, for any purpose, in perpetuity; and to use my name, likeness and any other information I provide to the WinVirginia in WinVirginia Communications. I hereby release WinVirginia from and against any and all claims, demands and causes of action of every kind and nature, which I may now have or hereafter acquire, arising out of or in connection with my appearance in the WinVirginia Communications or my participation in their production and use, including, without limitation, any claims, demands and causes of action for invasion of privacy or publicity, defamation, libel, personal injury, infliction of emotional distress and any other tort in connection therewith.

I agree.

WinVA 2019 Candidate Training RSVP

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