Together We Can
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Email address *
Name *
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Phone #
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What Town, Village, and/or City do you live in?
Your answer
What county do you live in?
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I'd like to help by:
Running for office
Signing a petition so someone can run for office
Putting a sign in my yard
Buying a t-shirt
Donating money
Table - talking to people at local events
Choose all that apply
I'd like to help by:
Making phone calls
Transporting people to polls
Delivering yard signs
Knocking on doors
Joining my local democratic committee
Choose all that apply
I'm willing to:
Sign a petition on an issue
Register voters
Host a meet and greet
Help with fundraising
Create campaign materials
Choose all that apply
Issues that are important to me:
Not important
Slightly important
Important
Very important
Extremely important
No opinion
Creation of living wage jobs
Social justice
Protecting social security
Tax reform
Lowering the deficit
Gun violence
Protecting the environment
Education
Addressing crime
Reducing taxes
Affordable health care
Political corruption
Campaign finance
Please list other issues or concerns you have:
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Thank you!
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