PLEASE BE AWARE THAT THIS QUESTIONNAIRE

WILL BE PUBLISHED.

The News-Herald
Election Questionnaire
,~_Iitical Name?/U/\I\.J Age:~
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Date questionnaire completed:

17

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Homeadd~ss: Length of resicten~e~~that ~ommynity: Occupation: Marital status: tl-,Name and age of any children:

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Gender: Male ~ e (circle one)

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Political office held

Municipality

Years served

Elected or appointed~

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4. 5. School!citv!state Years De~ree-Subiector

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Political office held

1.

Municipality

Years served

Elected or appointed?

2.
3.

4.

Education:

(Note: Only list schools from which you've graduated and/or earned degrees. Please indicate if currently attending.) (Note: If you've completed a certificate program, please list in "Other" row and indicate certificate obtained.) Should you be elected, what are three specific areas you'd like to change, address, improve or further research, and how spe7\fically would you go about it?
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