FEDERAL LEGISLATIVE CANDIDATE Company 1. Personnal Information Full Name * Sex * Male Female Age * Less than 18 18-30 31-40 41-50 Above 50 Email State * Abuja fct Abia Adamawa Akwa Ibom Anambra Bauchi Bayelsa Benue Borno Cross River Delta Ebonyi Edo Ekiti Enugu Gombe Imo Jigawa Kaduna Kano Katsina Kebbi Kogi Kwara Lagos Nasarawa Niger Ogun Ondo Osun Oyo Plateau Rivers Sokoto Taraba Yobe Zamfara Constituency of Origin * Kindly download the senatorial list in the introductory page and input your Constituency of Origin below 2. Your Nominee Information Section 2.1 Office of Legislature (Senate or Rep) Candidate Full Name * State of Origin * Abuja fct Abia Adamawa Akwa Ibom Anambra Bauchi Bayelsa Benue Borno Cross River Delta Ebonyi Edo Ekiti Enugu Gombe Imo Jigawa Kaduna Kano Katsina Kebbi Kogi Kwara Lagos Nasarawa Niger Ogun Ondo Osun Oyo Plateau Rivers Sokoto Taraba Yobe Zamfara Which of the offices is the nominee being nominated for? * Senate House of Representative His/Her Last or Current Occupation (If You Know) Ranking of Quality of the Candidate (Select the rating of personal quality from 1 – 5) While Range 1 is Very Poor, Range 5 is Exceptional Taking responsibility for others * I don't know 1 2 3 4 5 Integrity * I don't know 1 2 3 4 5 Empathy * I don't know 1 2 3 4 5 Selflessness/Ability to make Sacrifices * I don't know 1 2 3 4 5 National Patriotism in Attitude * I don't know 1 2 3 4 5 Humility * I don't know 1 2 3 4 5 Technical Competence * I don't know 1 2 3 4 5 Education * I don't know 1 2 3 4 5 Tolerance for diversity * I don't know 1 2 3 4 5 Zero Tolerance for Corruption * I don't know 1 2 3 4 5 Other Reason(s) for Nomination short comment 3. Your Civic Power Do You Have Your PVC? * Yes No If No, why? Did you Vote for Legislative in the 2019 Elections? * Yes No If No, why?
