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LGBTQ+ Victory InstituteTrainingsCandidate & Campaign Trainings2024: Application Southern Candidate & Campaign Training: Charlotte, NC

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2024: Application Southern Candidate & Campaign Training: Charlotte, NC

2024 Southern Candidate and Campaign Training in Charlotte, NC: April 11-14, 2024

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Contact Information
Name*
First Last
Email*
Enter Email Confirm Email

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Mobile Phone*
Include country code if outside the United States
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Demographic Information
Pronouns*
Race/Ethnicity*
- Asian/Pacific Islander
- Black/African American
- Latinx/Hispanic
- Middle Eastern/North African
- Multiracial
- Native American/American Indian/Alaskan Native
- White/Caucasian
- Prefer Not to state
Please choose the option that most closely matches your identity.
Which of these terms best describes your sexual orientation?*
- Gay
- Lesbian
- Bisexual
- Queer
- Pansexual
- Same-gender loving
- Asexual
- Heterosexual
Which of these terms best describes your gender/gender identity?*
- Transgender woman
- Transgender man
- Cisgender woman
- Cisgender man
- Gender non-conforming
- Genderqueer/non-binary
- Intersex
- Two spirit
Date of Birth*

Enter Date of Birth (MM/DD/YY)
Please select your generation:*
Political Party*
- Democrat
- Republican
- Independent
- No Affiliation
- Prefer Not to State
Please select the option that most closely aligns with your political party.
Which of the following best describes your political views?*
- Very Conservative
- Conservative
- Moderate
- Progressive
- Very Progressive
- It Depends on the Issue
- Not Sure/I Don't Know
- Prefer Not to State
Are you a veteran?
- Yes
- No
How do you describe your current marital status?*
- Married
- Unmarried
- Unmarried but in a Long-term Relationship
- Widowed
- Prefer Not to State
Do you live with a disability and/or chronic physical or mental health condition?*
- Yes
- No
- Prefer Not to State
Are you a primary caretaker for others (e.g. child[ren] or someone who is elderly, ill, or disabled)?*
- Yes
- No
- Not Sure

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Application Materials and Professional Background
Professional Headshot*
Max. file size: 49 MB.
Please provide a professional headshot. Must be high-resolution (not grainy) as this will be used along with your bio for all attendees to have. No selfies.
Professional Biography*
Please provide your professional biography in no more than 200 words. Your bio must be written in third person and it will be shared with fellow trainees, if selected.
Statement of Interest*
In 50 - 100 words, briefly explain why you are interested in the LGBTQ+ Candidate & Campaign Training and what you hope to learn from the training program.
Campaign Interest*
- I am LGBTQ+ and currently running for office.
- I am LGBTQ+ and I'm seriously considering a run for office.
- I am currently a campaign manager, staff or volunteer for an LGBTQ+ candidate.
- I am seriously considering become a campaign manager for an LGBTQ+ candidate.
- I am not interested in running for office or serving as a campaign manager
What level of office are you running for or hope to run for in the near future?*
Please specify type of office (ie: city council, state legislature, congress, etc), district, ward, etc.
When do you plan on running?*
- Within the next six months
- Within the next year
- Next two years
- Next 3-5 years
- Not applicable (not running at the moment)
What is your biggest concern about running for office (or managing a campaign)?*
In 50 - 100 words, briefly share a concern you hold about running for office (or managing a campaign).
Political Experience*
- I have worked on a political campaign.
- I have run for public office.
Occupation*
Employer*
Social Media Handle

Optional: provide your social media handle for tagging in future posts by LGBTQ+ Victory Institute.
Participation Commitment*
- Yes.
- No.
If admitted to this program I commit to attending every day of the program for its full duration, including evening group homework sessions, to the best of my ability. Please note that the training programs generally begin at 5pm on Thursday and end at 12pm on Sunday of the dates listed.
COVID-19 Vaccination Status*
- Yes, I am fully vaccinated and my last shot was/will be completed at least two weeks before the beginning of the program.
- No, I am not fully vaccinated and will not be completed at least two weeks before the start of the program.
All participants are required to be vaccinated against COVID-19 and will be asked to provide proof of vaccination.

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Professional Reference
Please provide one professional reference from an individual that could explain why you should attend the Candidate & Campaign Training.
Name*
First Last
Email*
Phone*
Occupation*
Employer*
Reference's Relationship to You*

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Additional Information
Do you have questions or comments for the LGBTQ Victory Institute?
Have you participated in any LGBTQ+ Victory Institute programming in the past? If so, select any programs you have been a part of.*
- I have not participated in any LGBTQ+ Victory Institute programs before.
- Victory Congressional Internship
- Victory Congressional Fellowship
- Victory Empowerment Fellowship
- LGBTQ+ Leadership Summit
- International LGBTQ+ Leaders Conference
- Women Out To Win
- Elected Official Summit
- Political Appointments Program
- Other
Where did you hear about the Candidate & Campaign Training?*
- LGBTQ+ Victory Institute Website
- Facebook
- Twitter
- Snapchat
- College/University
- Friend
- Elected Official
- Search Engine
- Previous Victory Institute Program
- Other
Name
This field is for validation purposes and should be left unchanged.

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2024: Application Southern Candidate & Campaign Training: Charlotte, NC

Step 1 of 5

Contact Information

Demographic Information

Application Materials and Professional Background

Professional Reference

Additional Information