ARP Candidate Enorsement Request

You do not have to be a member of the American Reform Party (but it wouldnt hurt) or any other political party to gain the endorsement of the ARP. However, we agressively support any candidate that supports a majority of our ARP Platform

Please complete the below questionaire for ARP Endorsement. Items marked with "*" require your response.

WE ARE CURRENTLY EXPERIENCING A TECHNICAL PROBLEM WITH THE BELOW FORM. PLEASE SEND US AN EMAIL WITH YOUR RESUME STATING WHY YOU WANT TO RUN, YOUR EXPERIENCE IN POLITICS, FINANCIAL BACKING, AND OFFICE YOU ARE SEEKING TO: mfsimone@americanreform.org Thank You

Endorsement Request Form & Questionaire

First Name *
Last Name *
E-mail address *
Office Sought *
Will Run As A *

PERSONAL DATA
Name As It Will Appear on ballot *
Street Address *
City *
State *
zip*
Phone*
Cell Phone
Fax Number
Marital Status*
Number Children *
Education *
Occupation*
Brief Work History*
Military history: Where, When, Rank, Discharged *

POLITICAL BACKGROUND
Do you currently hold Politcial Office? YES NO
Politcial Office currently held?
Have you ever run for Politcial Office? YES NO
If above answer is yes give details & results
Political Experience
Current Political affiliation
What are your Political Aspirations

YOUR STAND ON THE CURRENT KEY ISSUES
Do you think it is practical and advisable to reduce the national debt 50% by year 2020? YES NO
Do you think a portion or all of any future windfall ‘surpluses’, remaining or re-paid TARP or Stimulus funds should be mandated for paying down the National Debt? YES NO
Do you think the US Congress could/would/should pass a law/Constitutional Amendment requiring the Federal Government to have a annual balanced budget? YES NO
Do you agree that a constitutional Amendment should be passed imposing term limits on both the Senate and Congress of no more than two terms for Senate and six terms for Congress? YES NO
Do you believe that any public official, including elected state and/or federal officers, should be subject to recall by their constituents? YES NO
Do you agree with and support the Repeal of the Health Care Reform Law including the governmnet commondering and total control of the student loan program? YES NO
Do you favor reform of the Health Care industry including TORT Reform, open intersate competition, more strict guidlines on long and short term coverage? YES NO
Do you feel that the IRS and the present income Tax system can be simplified, reduced in size or perhaps eliminated altogether? YES NO
If you support abolising the current Income Tax System in favor of a more fair taxing system which most closely represents your choice? Flat VAT
Fair Other
Do you think the Federal Government should be made more efficient and cost-effective by consolidation of agencies and their assigned functions, even if it meant the lay off of 1000s of government employee‘s including some of your constituency? YES NO
Do you believe that Social Security cost/benefits can be improved without increased premiums? YES NO
Do you believe that Medicare/Medicaid cost/benefits can be improved without increased premiums? YES NO
Are you in favor of revision of our immigration laws/quotas in such a way that would take into account future social and economic stability while still preserving the historical tradition of our nation as the worlds melting pot? YES NO
Do you support the Audit of the Federal Reserve on an annual basis? YES NO
Do you believe that the proposed Cap and Trade legislation should be passed into law? YES NO
Do you believe Congressional Districting (gerrymandering) ought to be implemented by the court or the citizens of the community, not by political parties? YES NO
Do you believe that the continued independence and continuing world leadership of this nation depend on a broad manufacturing, agricultural and ecological base, not the globalization of all our human and natural resources to the service of international Corporations?
Do you support the total abolition of “soft money” campaign contributions from any sources? YES NO
If asked by a colleague, would you be willing to sponsor/co-sponsor a Pension/retirement/HMO plan bill for yourself and your colleagues with the same level of benefits/payments currently in practice in the private sector, for your public service salary level? YES NO
Attach Summary of your position on other issues you view as important ant that we did not cover above

YOUR CAMPAIGN APPROACH
What makes you think you can win an election?
What do you plan to accomplish if you win the election?
Do you have a campaign manager and staff?
In our effort to evaluate the possibility of a successful campaign we would like to know a little about your campaign strategy. This information will never be published and will be kept in confidence.
Do you intend to wear out some shoe leather in a door to door campaign?
Are you going to use newspaper ads (local or national ), bill boards?
Do you have plans for a fund raising effort? If so, what are those plans?
You do not have to be a member of the American Reform Party or any other political party to gain the endorsement of the ARP (but it wouldn"t hurt). You just have to be the kind of person who favors a big piece of the American Reform Party Platform
If you are endorsed by the American reform party, and if you are thereafter elected, do you promise to TRULY serve, protect and defend ALL the elements of the Constitution of the United States of America and not just the parts with which you happen to agree, and to that end, you will not sacrifice your own personal integrity, nor the integrity of this Nation and this Party, for political expediency or personal gain?
YES, I promise to truly serve, protect and defend NO, I do not promise to truly serve, protect and defend
PLEASE USE THIS SPACE FOR ANY ADDITIONAL COMMENTS OR QUESTIONS
YOUR PRIVACY CONCERNS:
Your Stand On The Issues will not be made public unless you add your permission to do so. NOTE: ALL PERSONAL DATA WILL ALWAYS REMAIN PRIVATE.
Private or Public? *