Get Involved with #Rheingans4Rep

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Help to re-elect Rep. Carrie Rheingans to the State House of Representatives! Please fill out this quick form with your info and what activities you would be interested in participating in. Let's send Carrie back to Lansing for a second term in 2025!

First Name *

Last Name

Email Address *

Phone Number *

Volunteer Activities - Please select all that you may be interested in! *

Canvassing / Door Knocking

Phone Banking/ Text Banking

Attend an Event or Fundraiser

Host a House Party

Drop off Yard Signs

Required

Select Your T-Shirt Size

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Carrie Rheingans for State Representative . Report Abuse

Forms