Campaign Connection
Thank you so much for being interested in supporting the re-election campaign for Doll, Roer, & Sparks!
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email (If you are Centerville staff, please remember to give your personal email address.) *
Cell Phone Number
Street Address *
May we send you campaign update emails to keep you informed? *
Do you have a positive testimonial to share about our school board members - Doll, Roer, or Sparks?
Would you like to help with materials assembly and/or distribution?
Clear selection
Would you like to help at events?
Clear selection
Would you like to help on Election Day?
Clear selection
May we contact you as volunteer opportunities arise? *
Would you like to have a YARD sign? *
Would you like to have a WINDOW sign?  (This is a great option for businesses, apartments and condos!)
Clear selection
If requesting a yard or window sign, please tell us which elementary school you live closest to, so we can determine our delivery routes.
Clear selection
Please share any other information you'd like us to know.  Thank you!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report