Endorsement Request Form First NameLast NameAddressAddress Line 1Address Line 2CityStateZipCountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweEmailPhoneWhat office are you running forGovenorLt GovenorSecretary of StateAttorny GeneralBoard of EquilizationUS SenateCongressState Senate District 4State AssemblyCounty Superintendent of SchoolsStanislaus County Board of EducationAssessorAuditor-ControllerCounty Clerk-RecorderTreasurer-Tax CollectorSuperior Court JudgeDistrict AttorneySheriff-CoronerBoard of SupervisorYosemity Community College District (YCCD)MayorCeres Council MemberCity of Hughson At-LargeModesto City CouncilCity of Newman At-LargeCity of Oakdale At-LargePatteron Council MemberRiverbank Council MemberTurlock Council MemberWaterford Council Member At-LargeModesto School BoardCeres Unified School DistrictDenair Unified School District – At-LargeOakdale Joint Unified School DistrictBoard Member – Area Board Member – Area 1Board Member – Area 2Board Member – Area 3Board Member – Area 4Board Member – Area 5Board Member – Area 6Board Member – Area 7District District 1District 2District 3District 4DistrictDistrict 9District 22DistrictDistrict 5District 9District 13DistrictDistrict 1District 2District 3District 4District 5DistrictDistrict 1District 2District 3District 4District 5District 6CityCeresHughsonModestoNewmanOakdalePattersonRiverbankTurlockWaterFordDistrictDistrict ADistrict BDistrict CDistrict DBoard Member – Area Board Member – Area 1Board Member – Area 2Board Member – Area 3Board Member – Area 4Board Member – Area 5Have you run for office before, & if what officeYesNoWhat job do you hold now?How long have you been registered as a Republican?PreviousNextWill you endorse a non-Republican when an endorsed Republican is running for the Yes NoHave you received any endorsemnts Yes NoPlease List your EndorsementsWhat do you think about Ronald Reagan’s 11th commandment:What are your top three issues for this campaign?Why are you running?What do you hope to accomplish?Have you been, or do you expect to be, covered negatively by the press? If so, please summarize critical coverage.Do you have experience speaking to the press? Have you done interviews?Why should voters consider you to be a good choice for this elected office? What are your qualifications to run for this office? What makes your district unique and winnable?What is something interesting about yourself that you would like people to know? Does not have to be campaign related.What is your understanding of how the RPSC can help candidates such as yourself?Submit Previous