Professional Documents
Culture Documents
lO'fZ
lection Question
na
re
Political party:
ttLvna-\*tz
Name:
Ch"igt-Nz
J. Port
t-t-q\o\
7l rtW -il-rrPlace of birth:
aee, 5\
Home address:
Date of birth:
community,
Ca
rnpaignWebsite tnJt$\$
Employer:
occupation'
Ft
Maritalstatus: \\nrC-Aien
Name and age of any children:
Name of
spouse:
\MaU F<+'J"nko
Additional comments:
)ot
Would you prefer this as an electronic copy? lf so, please contact Cynthia Buchanan at 44O-954-71g9.
NOTE TO CANDIDATES: Please be aware