Countryman Consultancy - Campaign Intake Form

Name Prefix*

First Name*

Last Name*

Role/Title*

Primary Phone*

Primary Email*

Preferred Method of Contact *

Campaign Status*

Office Being Sought*

Candidate Name*

Legal Committee Name*

Campaign Launch?*

Election State*

Election Date(s)*

Estimated Campaign Budget*

Current Team*

Campaign Website (optional)

Primary Decision Maker(s) (Name, title)*

Social Media Links (optional)

How soon do you need consulting support?*

Campaign biggest challenges currently?

What services are you interested in?*

Campaign Strategy

Messaging & Communications

Fundraising Strategy

Accounting Services

Digital Campaign Strategy

Field Organizing

General Campaign Management

Compliance Guidance

Voter Targeting / Data

Trainings

Path to Victory

Not sure – need guidance

Additional Information