Candidate Application

Submission Deadline: November 29, 2019


If you have any questions prior to filling out this form, please contact either Blaine Barklow at 503.580.0822 or Leslie Cross at 503.949.5683. 

Name *
Date of Birth *
Date of Birth
Address *
Phone *
This is the topic/issue you will spend your year of service advocating for, and should be something you are passionate about. Something you can speak from your heart about. Something that you can easily explain to people when at an appearance.