|
I am ready to help the Hagelin 2000 campaign:
|
|
Phoning/Mailing
|
Contacting the Media
|
|
Distributing Materials
|
Fundraising
|
|
Providing Referrals
|
Setting Up Speaking Venues
|
|
Organizing Tours
|
Distributing Yard Signs
|
|
Student club activities
|
|
Sharing Expertise:
|
|
Other:
|
|
|
I am ready to coordinate at the following levels:
|
|
Local
|
National
|
|
State
|
School
|
|
|
I am ready to be a State Party Leader:
|
|
State Chair
|
Media Chair
|
|
Treasurer
|
Volunteer Coordinator
|
|
|
I am interested in the following issues:
|
|
Health Care
|
Education
|
|
Safe Food
|
Environment
|
|
Agriculture
|
Crime Prevention
|
|
Campaign Reform
|
Economy
|
|
World Peace
|
|
|
Other:
|
|
|
Check here if you'd like to receive our free information packet.
|
|
Would you like to subscribe to our Email News Flashes?
Yes
No |
|
Comments:
|
|
|
Required fields are in RED
|
|
Email Address:
|
|
|
First Name:
|
|
|
Last Name:
|
|
|
Street Address:
|
|
|
City:
|
|
|
State:
|
|
|
Zip Code:
|
|
|
Phone Number:
|
Home
Work
|
|
Fax Number:
|
|
|
I am a student.
|
|
School:
|
|
|
|
