Our Massachusetts: Homes for a Thriving Commonwealth Coalition

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Name *

Phone Number *

Email Address *

City/Town of Residence *

Industry *

Employer *

Title *

Where does your company conduct business? (Check all that apply) *

Cape Cod & Islands

Central Mass

Greater Boston

Merrimack Valley

MetroWest

North Shore

South Coast

South Shore

Western Mass

Required

Number of Employees (if applicable)

Would you like to be listed as a coalition member representing yourself as an individual or on behalf of an organization? *

Myself

Organization

Both

If you answered "Organization" or "Both" above, please upload a high-resolution image of your organization's logo here.

Alternatively, you can send your logo directly to mcasavant@dewitimpactgroup.com.

If you answered "Organization" or "Both" above, and would like to add additional people from your company to the distribution list, please include their name(s) and email(s) below.

Which of the following actions are you interested in? (Please check all that apply) *

Lending your name to the list of coalition members & sign-on statement (your name will never be used publicly without your permission)

Meeting with legislators (schedule permitting)

Testifying at state and local hearings (schedule permitting)

Assisting with identifying and/or recruiting coalition members

Submitting op-eds or letters to the editor (drafted for you)

Speaking with reporters (talking points provided)

Required

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