Candidate Filing Application Request

Candidate Filing Application Request
Candidate Name*
Date of birth*

MonthDayYear
Phone Number*
Email Address*
example@example.com
Residence*

Street Address

Street Address Line 2

CityState

Zip Code
My mailing address is the same as residence*

YesNo
Mailing address*

Street Address

Street Address Line 2

CityState

Zip Code
Office Sought*
Division/District

N/ACommunity ServiceFire DepartmentMunicipalitiesPublic UtilitiesAirport DistrictsHospital DistrictsParks & Recreation DistrictsSanitary DistrictsSchool DistrictsWater Districts
PRIVACY

This information will only be visible to you and verified Nevada county officials.
Date (for file name)

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty: