PAC Endorsement Request

To be considered for PAC endorsement, you must be a candidate for a state-level office in Ohio. By law, federal-level candidates cannot receive OCHCH PAC funds. Candidates may be asked to complete a legislative survey and/or participate in a candidate screening meeting to determine endorsement or PAC support.
Please note that you cannot save your work on this form. Therefore, you may want to answer the questions using a Word document and then cut and paste your responses into this form when ready to send to us.

Candidate Information

Full Name
Address
City
State
ZIP Code
Telephone
Email
Office Seeking
District (If Applicable)
Incumbent
Primary Election
General Election
Party Affiliation
Candidate Experience/Rationale for Support by OCHCH PAC

Committee Information

Committee Name
Committee Contact Person
Campaign Mailing Address
Campaign Telephone
Campaign Email
Thank you for your request for support by OCHCH PAC.