H-CAN Registration Form
Havertown-Area Community Action Network (H-CAN) is a group working together to uphold progressive values and encourage political action.

After you register, you will receive an email in 24-48 hours with information on how to join our Action Groups. Thank you!

Feel free to email HCANWelcome@gmail.com if you have any questions!

Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Are you an elected official? *
If you are an elected official, what is your title?
Your answer
How did you hear about H-CAN? *
Please be more specific - from which event or friend did you hear about H-CAN? *
Your answer
A copy of your responses will be emailed to the address you provided.
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