Get Involved
Thank you for wanting to help make Springfield work for working families. Please fill out the form below and we will be in contact with you.
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
ZIP Code *
Your answer
I would like to:
(mark all that apply)
Your answer
Never submit passwords through Google Forms.
This form was created inside of Kacie Weicherding for State Representative. Report Abuse