Name *

First Name

Last Name

Phone

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Would you like to volunteer? *

Yes

No

Do you have a problem with standing long periods of time? *

Yes

No

Check all roles that interest you. *

Not Interested at this Time

Phone Banking

Door Canvassing

Pass Out Literature Outside of the Poll Stations Election Day

Distribute Yard Signs & Handbills

Host a Meet & Greet

Set Up a Table at Events