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2012 Voter Project Application Form
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Organizational Information
Executive Director Contact Info (if not the same as the Contact Person above)
Director Name
Director Email
Director Phone
Organization Name
The name of the organization you are affiliated with.
Street Address
Street Address Line 2
City
State/Province
Postal Code
Organization Phone
Fax Number
Organizational Email Address
Website
Contact Person for this application
First Name
Last Name
Job Title
Phone Number
Email
Is your organization a 501(c)3?
Yes
No
Do you have a 501(c)4?
Yes
No
Annual Budget
Size of Staff
Number of Offices
Constituency Served
Which Organizing Networks are you a part of?
Have you partcipated in any of PTP's previous trainings?
Yes
No
If so, which trainings have you participated in?
Organizational Overview (please be very brief)
Organizational Goals for 2012
Voter Engagement Goals for 2012
List of staff members who work on voter engagement activities. Give an approximate percentage of their time associated with voter engagement work:
What voter database or files will you be using? (e.g VAN, PDI, etc.)
Will you be getting assistance from other consultants or organizations with your voter engagement work this year? (Please describe)
Please list the primary contacts for the following (as applicable):
Communications Lead's Name
Communications Lead's Email
Lead Organizer's Name
Lead Organizer's Email
Technology Lead's Name
Technology Lead's Email
Development Lead's Name
Development Lead's Email
Voter Engagement Organizer Lead's Email
Voter Engagement Organizer Lead's Name
Summer Camp Voter Prep Shakedown July 30 - August 2nd
Who do you plan on sending to this training?
Person 1: Name
Person 1: Job Title
Person 1: Email address
Person 2: Name
Person 2: Job Title
Person 2: Email address
Person 3: Name
Person 3: Job Title
Person 3: Email address
Person 4: Name
Person 4: Job Title
Person 4: Email address
Person 5: Name
Person 5: Job Title
Person 5: Email address
Can you commit to sending at least two (2) staff members to this training?
Yes
No
Consulting / Technical Assistance
Who will be the Project Manager for the Voter Project? (if selected)
Name of Project Manager
Title of Project Manager
Project Manager Email
Project Manager Phone
What do you need help with in regards to your voter engagement work?