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HOUSE OF DELEGATES
CANDIDATE QUESTIONNAIRE
Full Name:_________________________________________________
Address: ________________________________________________
E-Mail: ___________________________
Precinct where you vote: _______________________________________
Do you live within the 10th Delegate District:? Yes / No
List all Telephone Numbers: ____________________________________
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I.
INSTRUCTIONS TO CANDIDATES
1. This form must be fully completed and returned to the Chairman of the Wood County Democratic Executive Committee, Walt Auvil, 1208 Market Street, Parkersburg, West Virginia. Forty copies of the form are required to accommodate all members of the Committee receiving the forms as quickly as possible.
2. This form must be received no later than 12:00 Noon, Friday, December 22, 2006. Because of the short time within which the Executive Committee must act on this matter, combined with the intervening Christmas holiday, the untimely filing of or submission of an incomplete application may preclude consideration of your candidacy.
3. If you need additional pages to fully respond, set forth the question in full and the response on a separate page(s).
4. If you wish, you may include your current resumé with this form.
5. There will be a Special Meeting of the Wood County Democratic Executive Committee on December 27, 2006 at 6:00 o’clock p.m. at the public meeting room at the Donald F. Black Courthouse Annex on 319 Market Street, Parkersburg, WV. At this special meeting, the Committee will consider all applications and vote on a list of three persons to be submitted to the Governor for appointment to this position.
6. Applicants will be considered without regard to race, gender, age (over 18), handicap, national origin, religious preference, or ethnicity. Non- traditional candidates are strongly encouraged to apply.
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