Candidate Application (Short Form)

The Entrepreneur's Network is sponsoring a national election for the offices of city mayor, state governor, and YGA/U.S. President. These are positions designed for our business associates to create, develop, and promote positive activities for young people. Become a part of a program with first year projections of revenues of $5 million dollars. This is a direct marketing program that will produce income for you and young people you recommend.
Name (optional): 


  1. Last Name, First Name, Middle Initial


  1. Age
    18-20
    21-25
    26-30
    31-35
    36-39


  1. Mailing Address: (Your Street/PO Box)


  1. Mailing Address: (Your City, State, Zip)(This is the city you will represent)


  1. Phone (Optional)


  1. Email


  1. Select the office(s) for which you will be a candidate.
    City: Council-member
    City: Mayor
    State: Governor
    National: President


  1. Reason for running for the selected office? (50 words or less)


  1. Create a Password (4-8 characters)