2016 Presidential Ballot Access Petition Request - Platinum Level

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  • Your Info 2
  • Payment 3

$10.00

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Employer Info

Law requires we ask for your employer and occupation. If you don't have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.
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By clicking on the "Contribute" button, you confirm that the following statements are true and accurate:
  • I am not a foreign national who lacks permanent residence in the United States.
  • I am an individual, and this contribution is made from my own funds, not those of another.
  • I am at least eighteen years old.
State law requires that we collect and report the name, address, occupation and employer of individuals and businesses whose contributions exceed $100 in an election cycle. Donations are not tax deductible. Contributions from sources other than individuals must be made by check in the name of the organization. Contributions from foreign nationals are prohibited by law.

Click the NEXT button to process your order for the Platinum Level Petition Kit: independent contractor paperwork, twelve official copies of the ballot access petition form, instructions, and promotional materials.

Someone from the Petition Coordinator's team will contact you to interview you for paid petitioning as an independent contractor.  If you have questions please contact Carolyn Cosby, Ballot Access Petition Coordinator, at (770) 735-1568 or carolyncosby3@gmail.com.

You can help put a man on the ballot in Georgia with the honor and wisdom necessary to make decisions that will affect the lives and livelihoods of Americans!

Darrell Castle for President