2016 Candidate Resource Committee Confidential Referral Form
(For SRECs and County Chairmen only)
1. Candidate’s Last Name: / 2. Candidate’s First Name: / 3. Office/Position (include Pct./Place #): / 4. County: / 5. SD
6a. Your Home Phone #
( ) - / 6b. Your Work Phone #
( ) - ext. / 7. Your Fax #
( ) - / 8. Your Email address / 9. ’12 Hecht
%
10. Your Street Address / 11. City / 12. Zip
PLEASE PROVIDE THE NAMES OF THE FOLLOWING OFFICIALS AND CHECK WHICH POSITION(S) YOU HOLD.
13. Candidate’s County Chairman / 14. Candidate’s SREC Committeeman / 15. Candidate’s SREC Committeewoman
PLEASE USE THIS FORM TO CONVEY YOUR FRANK, HONEST, AND CONFIDENTIAL OPINION OF THIS CANDIDATE.
THIS FORM WILL BE SEEN ONLY IN EXECUTIVE SESSION AT CANDIDATE RESOURCE COMMITTEE MEETINGS.
Yes No 16. Have you personally interviewed this candidate?
Yes No 17. Have you asked this candidate if there is anything in
his/her background which he/she is not prepared to have
publicly exposed?
Yes No 18. Will active Republican leadership support this person over the Democrat? / Yes No 19. Is this Republican candidate working effectively and
productively?
Yes No 20. Is there a Democrat opponent in this race?
Yes No 21. Is the Democrat opponent working effectively and
productively?
22. Tell us your opinion about what kind of person this candidate is.
23. What is your analysis, based on facts or personal interview, of this candidate’s Party philosophy and Party participation?
24. What is your analysis, based on facts or personal interview, of this candidate’s qualifications for office and his or her campaign organization?
25. Describe any relevant facts that will shed light on the likelihood that this candidate can or cannot win this race.
PLEASE PROVIDE YOUR RECOMMENDATION AS TO WHETHER OR NOT THIS CANDIDATE SHOULD BE FUNDED.
REMEMBER THAT THE INFORMATION IN THIS REFERRAL WILL BE HELD COMPLETELY CONFIDENTIAL.
26. Funding Recommendation
Yes. The Candidate Resource Committee should fund this candidate.
No. The Candidate Resource Committee should not fund this candidate.
I have no opinion about whether or not this candidate should be funded. / 27. Provide any further information to support your opinion.
28. Signed / 29. Date
2016 CONFIDENTIAL REFERRAL FORM INSTRUCTIONS
(Form to be completed by SREC or County Chair only)
ITEM / COMMENTS1-5 / Information about the candidate
6-8 and 10-12 / Information about the SREC or County Chair filling out this Confidential Referral form
9 / Please provide the Texas Supreme Court Justice, Place 6 Nathan Hecht % of vote in the 2012 General Election for the candidate’s county or district. If you feel that the Perry numbers were skewed due to extenuating circumstances, enter the actual 2012 Hecht % in the box, but circle the entry and explain why they are skewed in Item 27.
13-15 / Please complete information about all three positions, and check the one that applies to you
16-27 / Please be as frank and honest as possible. The Candidate Resource Committee must make decisions on how to best use limited funds, and your honest assessment of the candidate will help us to use funds as wisely as possible. These forms will be sent directly to the CRC and will be reviewed only in Executive Session. No one outside the CRC will have access to your referral form. We will verify nothing to anyone outside the Candidate Resource Committee other than receipt or non-receipt of a referral from you. The information is confidential.
28-29 / Remember to sign and date the form
REMEMBER THAT FUNDING IS NOT GUARANTEED! FUNDS ARE LIMITED. YOUR PRESENTATION OF THE RACE AND THE CANDIDATE WILL HELP US PRIORITIZE THOSE FUNDS APPROPRIATELY.
Please address application questions to the CRC Chairman, Steve Atwell, via e-mail at
Submit by mail: Steve AtwellCRC Chair
7524 Mosier View Ct., Ste 230
Fort Worth, Texas 76118 / Submit by email:
Submit by fax: 817 595 2690
DUE: JUNE 1, 2016 01/14 CRC Application Form