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Get Involved!

Join the team. . .

First Name

Last Name

Business/
Organization

Home Street
Address


Address (cont.)

City

State

Zip Code

Work
Phone

Home Phone

FAX

E-mail


How would you prefer to be contacted?

by e-mail

at my daytime phone

at my evening phone

on my cell phone

by US mail

Have you ever worked on a
political campaign?

Yes

No

If yes, please list when and for whom:

Check all ways you might be interested in assisting a
campaign:

Put
a bumper sticker on my car

Block walk

Stuff
and/or address envelopes

Do
literature drops

Enter
information into a computer

Participate
in a sign standout

Send
“Dear Friends” cards

Host
a coffee or fundraiser in my home

Build
and/or put up signs

Assist
in the campaign office

Make
phone calls from my home

Help
with phone banking

Work
at the polls on Primary Day

Work
at the polls on General Election Day

Volunteer
time at a booth for a candidate

Stand
out at a polling location on Election Day