LEAP Initial Application - Education Minnesota

INITIAL APPLICATION: Intent to File a Reimbursement Application
Local Election Reimbursement
Education Minnesota PAC

"*" indicates required fields

President*

First Last

Treasurer*

First Last

Local*

Local President Cell Phone*

Local Treasurer Cell Phone*

Preferred address*

Street Address Address Line 2 City State ZIP

Local President Email Address*

Local Treasurer Email Address*

Type of election (choose all that apply)

School board election

Operating referendum

Bond referendum

Capital referendum

Date of election*

MN Campaign Finance Registration Number*

Bank Name*

Bank Account Number*