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Political Activity Notification Form

Political Activity Notification Form

Printable version

(please print)

 

_____________________________________, representing _____________________________,
                                                                                       candidate, organization, issues, etc.

has notified the CNM Public Information Office of intent to visit ____________________________
                                                                                                                     room/building

at _____________________________________ Campus on _____________________________
                       campus                                                                                   date(s)

during the hours of ______________________.

 

MCO Representative _____________________________________________________________
                                     name                                   signature                                   date

 

 POLITICAL ACTIVITY

Name(s) of visitor(s) ____________________________________________________________

Political office/issue ____________________________________________________________

Purpose of visit ________________________________________________________________

CNM sponsors name and phone number (if applicable) _______________________________

Date(s)/time(s) of visit(s) ________________________________________________________

___________________________________________________________________________

Course title (if applicable) ________________________________________________________

Location of activity _____________________________________________________________

List any special needs: ________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

Please submit samples of any materials to be distributed (optional).

XC to:           Visitor

                    VP for Administrative Services

                    Security