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PA Fellowship 2006 Application Form Part 1
When this form is completed the applicant is added to Group 46851 (PA 2006-2007 Fellowship Applicants (Step 1))
When this form is completed the applicant is added to Event 15410.
This form sends the following email triggers:
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The fields included are:
First_Name (First Name)
Last_Name (Last Name)
Email (Email)
Phone (Phone)
Street (Street)
Street_2 (Street 2)
City (City)
State (State)
Zip (Zip)
VARCHAR10 (What area of Pennsylvania do you live in or are you looking to impact politically?)
RADIO12 (What type of political leadership role are you interested in pursuing in the next 3-10 years?)
0 - Non-Profit/Advocacy Organization Leader
1 - Future Candidate
2 - Campaign Staff/Operative
3 - Political Party Leader
4 - Grassroots Activist/Community Organizer
5 - Non-Elected Government Official
6 - Other/Uncertain
RADIO9 (Are you interested in participating in the Springboard Training?* )
0 - Definitely Interested
1 - Somewhat Interested
2 - Uncertain
3 - Probably Not Interested
4 - Definitely Not Interested
VARCHAR22 (How did you hear about CPL? *)
VARCHAR4 (please elaborate)
RADIO0 (Gender)
0 - Male
1 - Female
INTEGER0 (Age)
RADIO2 (Ethnicity)
0 - African/African-American
1 - Asian/Pacific Islander/SE Asian/Indian Subcontinent
2 - Latino/Chicano
3 - Middle Eastern
4 - Native American
5 - Caucasian
6 - Other
VARCHAR0 (Ethnicity Other)
RADIO8 (Income)
0 - Under $20K
1 - $20K - $40K
2 - $40K - $60K
3 - $60K - $80K
4 - Over $100K
RADIO3 (Educational Experience)
0 - Some High School
1 - High School Grad
2 - Some College
4 - Bachelor Degree
5 - Some Grad School
6 - Masters Degree
7 - Some Post-Masters
8 - PhD/JD/MD
RADIO4 (Non Profit/ Community Organizing Experience)
0 - None
1 - 1-2 Years
2 - 3-4 Years
3 - 4+ Years
RADIO5 (Political Campaign / Organizing Experience)
0 - None
1 - 1-2 Campaigns
2 - 3-4 Campaigns
3 - 4+ Campaigns