First Name:
Last Name:
Address:
City:
State:
ZIP:
E-Mail:
Phone:
Areas in which I'd like to assist: (Check as many
areas of interest as you wish.)
Left click to select or deselect check boxes. Do not press Enter Key.
Work
on a committee
Help on Primary and/or Election Day, at polling
places or other activities
Work at headquarters, answer phones, clerical, mailings, etc.
Computer, data entry, desktop publishing, word processing
Distribute literature
Plan and
host a fundraiser
Make
phone calls from home
Put a sign in my yard or on my building
Put a
bumper sticker on my car
Comments:
Thank you for your support.
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