Request edit access
Join the Member Action Team!
Yes, I want to join the Member Action Team and pledge to build power for working people in Virginia by:

* Calling fellow members to keep them updated
* Signing up new members and COPE contributors
* Showing up and bringing members to rallies, budget hearings, lobby day, etc.
* Meeting with and building a relationship with my elected officials
* Communicating with union leaders and staff regularly

Name: *
Your answer
Personal Email *
Your answer
Best phone number to reach you *
Your answer
Are Texts Ok?* *
SEIU Virginia 512 will never charge you for texts, but your service provider may.
Address Line 1 *
Your answer
Address Line 2
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
The top 3 issues I want to work on and win are:
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms