PLEASE BE AWARE THAT THIS QUESTIONNAIRE WILL BE PUBLISHED.

The News-Herald

Date questionnaire completed:

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Election Questionnaire

Name:
Age:

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Gender: Male / Female (circle one)

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Home address:

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Public office experie ce:

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Political office held

Municipality

Years served

Elected or appointed?

1.
2.
3.
4.
5.

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Education:
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College
Graduate

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(Note: Only list schools from which you've graduated and/or earned degrees. Please indicate if currently attending.~~.7t:r
(Note: If you've completed a certificate program, please list in "Other" row and indicate certificate obtained.)
Should you be elected,what

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