Thank you for your interest in seeking the nomination of the Maryland Green Party. Please begin the process by completing this questionnaire. Please e-mail your responses to info@mdgreens.org. If you have any questions, please e-mail info@mdgreens.org or call 410-929-MGP1. Thank you! CONTACT INFORMATION Name: Address: Home Phone: Cell Phone: E-Mail: CANDIDATE BACKGROUND 1. Are you registered to vote as a Green? Yes/No 2. Are you affiliated with a Maryland Green Party Local? Yes/No If yes, please specify which local and have long you have been active: 3. Have you ever run for public office before? Yes/No If yes, please provide the following information: Elected Office: Party Affiliation: Percentage of Vote Received: 4. Do you expect to move from your current residence at any time before the election? If yes, please provide the address of your future residence: 5. Does the name on your voter registration card match the name you want to appear on the ballot? If no, please specify the name you want to appear on the ballot: ELECTION DETAILS 6. Office sought: 7. Length of term: 8. Date of election: 9. Name and party affiliation of incumbent: 10. Is this a partisan election (will party affiliation be listed on the ballot)? Yes/No 11. Responsibilities of office sought: CAMPAIGN ORGANIZATION 16. Who will serve as your Treasurer? Name: Address: Phone Number: E-mail: 17. Does your Treasurer have any campaign and/or financial experience? Yes/No If yes, please specify: 18. Would your Treasurer benefit from a training workshop? 19. Will you have a campaign manager? Yes/No If yes, name: Address: Phone Number: E-mail: 20. Will you have a press spokesperson? Yes/No If yes, name: Address: Phone Number: E-mail: CAMPAIGN ISSUES AND FINANCING 21. Please list three issues that your campaign will emphasize. Include a short explanation of your position on each: a. b. c. 22. Would you be willing to share information and/or coordinate some of your campaign activities with other Green Party campaigns? Yes/No 23. Will you keep a "campaign journal" to record events throughout your campaign? Yes/No 24. Are you willing to share your campaign experiences with the Maryland Green Party after the election? Yes/No 25. Have you written or published any pamphlets, essays, letters to the editor, etc explaining your views on public policy? Yes/No If yes, please provide an attached copy or specify the location where the document can be found. 26. Do you understand the Ten Key Values of the Green Party? 27. Are you aware of the Maryland Green Party's principles and guidelines regarding campaign finance? Yes/No 28. Please read the following and indicate that your campaign will follow the states guidelines outlined by the bylaws and resolution passed by the Maryland Green Party. a. Contributions or transfers of money from entities other than individuals are strictly prohibited. Such entities include, but are not limited to, corporations, unincorporated companies, political action committees, and unions. b. Candidates who wish to make financial contributions to their own campaigns are asked to observe a personal limit of $400. In order to protect the candidate from bearing too great a personal burden as well as to ensure that personal wealth does not become a de facto condition of candidacy, candidates are instructed to notify the Electoral Committee of the Maryland Green Party if they intend to contribute more than the stated financial limit. c. At the August 17, 2003 Coordinating Council meeting, it was determined by the Maryland Green Party that campaign finance limits regarding individual contributions are to be decided through consultation among the candidate, the nominating Local(s), and the Maryland Green Party. d. Individuals seeking to run as candidates of the Maryland Green Party must support Green values, as defined by the Ten Key Values (see www.gp.org). I have read statements 28(a-d) and agree to adhere to the guidelines set forth in the bylaws and resolutions of the Maryland Green Party. Signed, __________________________________________ date ____________