Survey - Member Political Profile - REALTOR Action Center

General

1.

Please provide the following:


*	First Name: Required
*	Last Name: Required
*	Email: Required
	Street 1:
	City:
	State / Province:
	ZIP / Postal Code:
	Phone Number:
	If you respond and have not already registered, you will receive periodic updates and communications from Realtor Action Center.
	Yes, I would like to receive postal mail from REALTOR Action Center

*2.

Question - Required - State of Voting Residence:

*3.

Question - Required - Name of your U.S. Representative or U.S. Senator with whom you wish to work:

*4.

Question - Required - How well do you know the lawmaker above?

NAR Activities

*5.

Question - Required - How many years have you been a REALTOR®?

*6.

Question - Required - Have you ever responded to an NAR Call for Action? Yes
No

*7.

Question - Required - Are you active in grassroots or in RPAC at the local, state, or national level? Yes
No

*8.

Question - Required - Do you contribute to the REALTOR® Political Action Committee (RPAC)? Yes
No

9.

Question - Not Required - Have you served on an NAR Committee? Yes
No

10.

Question - Not Required - If yes, please specify committee or committees and years served:

Political Activities

*11.

Question - Required - Are you registered to vote? Yes
No

12.

Question - Not Required - (Optional) Please provide your political party identification: Democrat
Republican
Independent
Other

13.

Question - Not Required - (Optional) Have you made a personal political contribution to the above lawmaker? Yes
No

*14.

Question - Required - Do you have any political experience? (Check all that apply)

	Campaign steering committee
	Campaign volunteer
	Fundraising
	Other
	None

15.

Question - Not Required - If Other, please explain:

*16.

Question - Required - Have you been politically involved in your community? Yes
No

17.

Question - Not Required - If yes, how have you been involved?

*18.

Question - Required - Have you ever held or do you currently hold public office? Yes
No

19.

Question - Not Required - Position held:

20.

Question - Not Required - Please list the dates of service:

*21.

Question - Required - Have you ever run for political office? Yes
No

22.

Question - Not Required - Position sought:

Other

*23.

Question - Required - How do you prefer that we communicate with you? Email
Phone

24.

Question - Not Required - Use the space below to tell us anything else that might help us better understand your political background. (Please limit your comments to 1000 characters)

Thank you for your interest in NAR's political programs.

REALTOR® Party Action Center

Member Political Profile