2024 Local screening form -

Local doing the screening(Required)

Date of screening(Required)

When did the screening take place?

Legislative district screened(Required)

Candidate Screened – 1

Candidate 1 – Name(Required)

Candidate Screened – 2

Candidate 2 – Name

Candidate Screened – 3

Candidate 3 – Name

Screening recommendation and notes

Recommended candidate(Required)

Recommendation rationale(Required)

If yes, what were the questions?

Of the candidates who screened, did anything stand out as especially positive or negative? Were there red flags or things to highlight? Please describe.(Required)

Vote tally – Yes

Vote tally – No

Vote tally – Abstained

Minority opinion

Date