PSA Legislative Champions Sign Up
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Home Address
Zip Code
Home Phone
Cell Phone
Email Address
What is the best way to contact you? (check all that apply)
Do you have a relationship with any Pennsylvania State Representatives and/or Pennsylvania State Senators?
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Please describe the relationship you have with the either the State Representative or State Senator
Are you willing to contact your Pennsylvania State Senator or State Representative as needed?
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Would you be willing to attend fundraisers on behalf of the PSA?
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Would you be willing to attend in person meetings with your Pennsylvania State Representative or State Senator?
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Would you be interested in a PSA legislative App for your smartphone?
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Are you on social media? (check all that apply)
What can we do to get you involved in advocacy?
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