Green Party of Kitsap County Candidate Questionnaire

The intention of this questionnaire is to assist the Green Party of Washington State (GPoWS) and/or any of it affiliated locals in assessing your qualifications, determination and viability as a candidate should you choose to run for office under the sponsorship of the GPoWS. Be advised, some of these questions are personal in nature. As such, you are under no obligation to answer any of them. Be advised that your answers to these questions will not be the sole determinants of GPoWS support or endorsement.

The GPoWS considers any information you choose to disclose on this document as private and highly confidential. The GPoWS will share such information only with those having an absolute need to know, strictly for the purposes of assisting you in managing, endorsing or materially supporting your campaign.

Should you choose to answer them, you will be asked to sign this document before witnesses, attesting that you believe there is nothing in your background that may embarrass or discredit the GPoWS or any of its affiliated locals.

Please answer the following questions to the best of your ability:

1. Are you currently a member of the GPoWS? Y / N

2. When did you first join the GPoWS? ___________________________________

3. If you are not a current member, please indicate why:______________________

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4. Are you a member of any affiliated or unaffiliated Green Party local in the State of Washington or elsewhere? Y / N

5. If so, which one and where: _________________________________________

6. Do you attend Green Party meetings? Y / N

7. Are you now or have you ever been a member of another political party? Y / N

8. If so, which one(s)?

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9. Have you ever run for or held any office, political, professional or other, prior to this?

10. If so, which office(s), where and when? __________________________________

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11. In what legislative district do you currently reside? ___________

12. Is that the district in which you are seeking office? Y / N

13. For which office are you planning to campaign?_________________________

14. Are you familiar with the Green Party’s Ten Key Values? Y / N

15. Do you endorse all of those values? Y / N

16. Briefly describe your platform?__________________________________________

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17. Briefly define your campaign strategy?___________________________________

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18. How much estimated time per week do you plan to spend campaigning?

19. Who is your base of support? Include prominent individuals, community leaders, professional or fraternal organizations and the like (use the reverse side if necessary):

Name Affiliation

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20. What audience do you intend to target in your campaign?___________________

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21. Briefly outline how will you plan to finance and/or structure your campaign?_________

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22. What endorsements do you have?_______________________________________

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23. What endorsements will you seek?______________________________________

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24. If you lose this campaign are you willing to seek office again? Y / N

25. What personal or professional experience do you feel qualifies you to seek office as a Green candidate?___________________________________________________________

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26. If elected, are you willing to meet with Green Party representatives and members on a regular basis? Y / N

27. If so, how often (circle one)? Monthly Quarterly Semi-annually Annually

Other: ____________________________________________________________

28. Have you ever been disciplined by any professional organization with which you’ve been associated? Y / N

29. Have you ever been disciplined or sanctioned by any legal entity for any reason? Y / N

30. Have you ever been convicted of a felony? Y / N

31. Have you ever spent time in prison? Y / N

32. Is there any information you wish to inform us of that might have a material bearing on the viability of your candidacy? Y / N

Please list three personal and three professional references. Be sure to let them know we will be contacting them.

Name Address or Phone Relationship

1. ______________________________________________________________________

2. ______________________________________________________________________

3. ______________________________________________________________________

4. ______________________________________________________________________

5. ______________________________________________________________________

6. ______________________________________________________________________

Due to the seriousness that the Green Party views political offices, be advised that, at our discretion, we may decide to complete a partial or full background investigation based on the information you have provided. To assist us in accomplishing that, please furnish the GPoWS with your Social Security number:

_________ - ______ - _________

 

 

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I have answered all the questions above to the best of my knowledge. I understand that in seeking this or any candidacy under the auspices of the Green Party of Washington State or any of its affiliated locals that I may be asked further questions regarding my responses to the above information. Should I choose to answer any follow-up questions, I will do so in an honest and forthright manner. I attest that my intentions for seeking office are honorable and consistent with the Ten Key Values of the Green Party Federation.

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Date

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Signature

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Printed Name

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Witness Signature