Appendix 10

By signing on to the National Slate of Independent Progressive Candidates, I:

1) affirm that I am an independent candidate or a candidate of an independent progressive party or parties for local, state or national office;

2) affirm that, if I am cross-endorsed by an establishment party (Democrat, Republican, Reform), my primary organizational commitment and accountability is to an independent progressive party;

3) affirm my agreement with the basic principles, though not necessarily every detail, of the Common Platform of national demands of the National Slate of Independent Progressive Candidates;

4) agree to allow my name, party affiliation, and office I am seeking to be included on lists of the Slate that will be circulated to the media and general public;

5) affirm the Slate's stated purpose of being a unity-building step toward a united, independent, progressive national party or alliance of parties of the people;

6) agree to report the election results in my race (number of votes for all candidates in my race) to the clearinghouse of the National Slate in Brooklyn so the combined efforts of the Slate can be reported to the public;

7) understand that as a member of the National Slate I retain my own party's identity on the ballot and affirm that my own electoral platform does not contradict the basic principles of the National Slate's Common Platform;

8) agree to circulate the Common Platform along with my own platform and campaign literature when and where it is appropriate;

9) understand that my address will be available to other candidates on the Slate and that I may contact other candidates on the Slate;

10) understand that I will receive periodic updates on the National Slate of Independent Progressive Candidates.

Address _________________________________

City _________________    State _____     Zip _______-_____

Phone _______________     Fax ______________   E-mail ______________

National Slate of Independent Progressive Candidates ◙ indpol@igc.apc.org