Candidate Application/Contract with the Christian Party of America
I, ___________________________, (hereinafter “the applicant”) request to be officially vetted and, if approved, endorsed by the Christian Party of America (hereinafter “CPA”) as its official candidate for the office of _______________________ for the ____ election cycle.
Personal Information:
Date___________
Name: ____________________________________________________
Names of other family members on application (if applicable):
1. 2. 3. 4. 5.
Mailing Address:____________________________________________
Physical residence (if different): ________________________________
City/Zip.: __________________________________________________
Home phone: __________________ Cell: ________________________
E-mail: ____________________________________________________
Website: ___________________________________________________
County and State of residence: __________________________________
I am a “full member” of the CPA. Yes __ No __ (Check the appropriate blank.)
I am not a member of any political party. Yes __ No __ (Check the appropriate blank.)
Membership in another political party disqualifies
an applicant from approval without exception.
I agree without reservation to the following:
1. I agree to conduct my campaign according to sound ethical, that is, Biblical Christian principles;
2. I agree to support of the “Principles” (and other founding documents of the CPA), the platform, and the overall goals of the CPA;
3. I agree that, if not approved for candidacy, I may not associate any subsequent campaigning for my desired office during the pending election cycle with the CPA and I acknowledge that I am not eligible for financial assistance from the CPA;
4. I agree that, if not approved for candidacy, I shall surrender any and all future claim(s) and complaint(s) against the CPA and its officers – they are fully indemnified -- and;
5. I agree that if I am approved for candidacy, and, then, violate one or more of the requirements for candidacy – even, if elected -- after having accepting financial support from the CPA, I must reimburse the CPA in full.
I certify my agreement to the provisions the CPA’s vetting program and the provisions of this contract, and, further, certify that all information entered herein is true and correct on this _________ day of ___________________, in the year of our Lord _____ by affixing my own true signature _____________________________________ of my own free will and with the full knowledge and understanding of my action of so doing.
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Notary’s Signature ________________________ Notary’s Stamp ________________________
Notary’s Printed Name _____________________Date ______________
For CPA Office use only
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Authorized CPA Representative’s Signature ________________________________
Authorized CPA Representative’s Printed Name _____________________________
Date ____________
Mail all completed forms to:
Christian Party of America
218 Chesterfield Circle,
Waxahachie, Texas 75165
Christian Party of America
218 Chesterfield Ctrcle Waxahachie, Texas 75165
Telephone #: 1-832-975-5058
www.christianpartyonline.com
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Attention Christian Lady Patriots
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CPA Principles and Full Member Pedge
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Full Membership Pledge Application
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