Camp Wellstone Request Form

We have many requests to bring Camp Wellstone to towns across the country, and unfortunately cannot accommodate all requests.

Please submit the following form to indicate your interest in bringing Camp Wellstone to your area.

First and Last Name: *

Job Title:

Organization: *

Street Address:

State: *

Zip Code:

Email: *

Phone: *

Cell Phone:

City: *

Desired location (city, state): *

Partnership/ Support (please check all questions for which your answer is "yes"): *

Have you generated interest/support from individuals or organizations?

Are you located near college campuses/ be able to draw student turnout?

How many participants can you commit to recruiting?:

Please list potential partner organizations/individuals:

(provide a brief description if necessary)

What elections are on the ballot this year? (check all that apply): *

Municipal

State

Federal

Other

If other, please specify::

Primary Election Date::

General election date:

Are there any major issue campaigns/ ballot initiatives?:

If yes, what are they?:

Please provide your first, second, and third choices of dates for the training. Camp Wellstone runs Friday - Sunday. Please note that trainings require at least three months advance planning.

What is your first choice date for the training?: *

(trainings begin on Fridays)

What is your second choice date for the training?: *

(trainings begin on Fridays)

What is your third choice date for the training?:

(trainings begin on Fridays)

Is there a venue large enough?: *

Yes

Venue must accommodate 150 people with three breakout rooms

Additional comments:

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CAMP WELLSTONE REQUEST FORM