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PLEASE

aE AWARE

THAT THIS QUESTIONNAIRE

WILL BE PUBLISHED.

The News-Herald
Election Questionnaire

Date questionnaire completed:

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Political party:

Name:~O(Ce
Age:

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Gender: Male / B(drC'e one)

Horneaddress:Jdaa

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Employer:

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Length of residence in that community; ~

Campaign Web site:

Occupation:

T:eo.chec

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Maritalstatus:JC{)aC{(fd
NameandageOfanYChildren:~lO('I

Nameofspouse:-0Qbn

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Public office experience:


Political office held
l. 2.

Municipality

Years served

Elected or appointed?

3, 4.

S.

Non-elected

experience (committees,

boards, etc.):

--------------

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10/13/11

THU 07:40

[TX/RX NO 5207]

Education:
School/city/state High School College

Years

DegreeSubject or Certificate

Graduate
Other

(Note: Only Ilst 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 eJected, what are three
specific areas you'd like to change; address, improve or further

research,

and how

spec~kaJ~wouldyougoa~ut~?~~~~~~~~~~~~~~~~~~~

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10/13/11

THU 07:40

[TX/RX NO 5207]