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CANDIDATE INFORMATION
* Name
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* Email
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* Phone Number to Contact You
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* Campaign Contact (best person for SJA to contact -- if there is none, please enter the name of the candidate)
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* Campaign Contact Email
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* Campaign Contact Phone Number
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* Type of Office Sought
* Campaign Office Address
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* Campaign Website
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Campaign Facebook Account
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Campaign X/Twitter Account
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Campaign Instagram Account
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Other Campaign Social Media Account
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* When is Your Primary Election?
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* When is Your General Election?
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Other Endorsements You Would Like to Share
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* Current Elected Status
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* Party Affiliation
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* Tell Us About Yourself (write a 500-character bio that SJA can use on our website if we choose to endorse you)
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* Why Are You Seeking an Endorsement from SJA? (in no more than 500 characters)
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PLEASE RESPOND TO THE FOLLOWING QUESTIONS


Survivor Justice Action will use your answers to the following questions as part of our endorsement process.
* 1. Survivor Justice Action is committed to ending domestic violence in our lifetimes. Do you share that commitment?
* 2. Do you commit to supporting legislation, policies, and programs that protect those who experience or are impacted by domestic violence and their families?
* 3. Do you commit to supporting increased funding for services and programs that support those who experience(d) or have been impacted by domestic violence and their families?
4. Please feel free to share any additional experiences, background, or other information you think we should know (500 characters or less)
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* Signature
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* Date
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Survivor Justice Action | PO Box 92766 | Austin, TX 78709 US

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