Name:
Address 1:
Address 2:
City
State		Zip
Daytime Phone
Evening Phone
Email Address
Volunteer activity you'd be available for (please check all that apply)
	phone voters distribute literature (canvass) place a sign in your yard work election day at the polls general tasks (stuffing envelopes, etc.) other (please specify)
Please use this area for anything else you'd like to tell us, such as the best hours for you to work or campaign suggestions!