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The News-Herald

Election Questionnaire

Date questionnaire

completed:

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Politlcal party:_~~_~_~~~:......:..-_ Name: Age:

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Home address:

Length of residence in that community:

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Date of birth: Place of birth: Home phone: Campaign Web site: Employer: Phone:

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_ Occupation:

Business address:

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Elected offlce experlerice:

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Non-elected office experience (boards, etc.): h1~

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Educatio n (list degrees if app Iica b Ie): -I."..oC,..~'::,.LJ._.II.,A....t~~~..Ll-~!.L..IJ.,.~J..a:::J.~::::::::...

Marital status:

Name of spouse:

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Name and age of any children:

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Objectives:

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Would you prefer this as an electronic copy? If so, please contact Cynthia Buchanan at 440-954-7189. NOTE TO CANDIDATES:Please be aware that this will be used for publication, be complete and thorough.

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