PART 1. Please complete Part 1 of this form to send your message.
PART 2. Please complete Part 2 if you wish to VOLUNTEER your services. Your decision to volunteer your help to the political process is crucial, now
more than ever, and in view of the difficult issues facing the American People today. Your dynamic participation throughout this critical process
is highly appreciated. Thank You! Required information *
PART 1. SEND MESSAGE HERE. (continue with PART 2 if you are planning to VOLUNTEER) Click SUBMIT at bottom of this page.
Salutation | Saludo:
*
First Name | Nombre:
*
Last Name | Apellido:
*
City | Ciudad:
*
Zip Code | Código Postal:
*
If you Selected "Other" enter your zip code below Si seleccionó "Otro"
indique su Código Postal abajo.
Should match the e-mail address you provided above | Debe ser dirección electrónica igual a la anterior
Write any notes or message, suggestions, recommendations, comments, any information you'd like to
provide or receive from us.
Escriba aqui sus notas, mensaje, sugerencias, recomendaciones, comentarios, información que Usted desea enviarnos ó
recibir de nosotros.
PART 2. VOLUNTEER. (leave PART 2 blank if you do not wish to VOLUNTEER)
Cell Phone | Celular: (include area code | incluya área teléfono
*
Home Phone | Teléfono de Casa: (include area code | incluya área teléfono
*
Work Phone | Teléfono Trabajo: (include area code | incluya área teléfono
*
Fax | Facsimile: (include area code | incluya área teléfono)
*
Preferred Contact | Forma de Contacto: (check one)
*
Email
Cell Phone
Home Phone
Fax
Volunteer | Voluntario(Check all that apply | Marca una ó más.)
I will help by performing the following tasks | Yo ayudaré cooperando con los siguientes trabajos:
*
Select one or more | Seleccione una or mas
Driving voters to the Polls | Puedo llevar votantes a las urnas electorales
I need a ride to the polls | Necesito transportación para votar
Distribution, flyers and campaign material | Distribución de volantes
Walk door-to-door, talk to people | Ir a las casas, hablar con los votantes
Mailings from Headquarters | Correspondencia
Placing lawn signs | Colocando Letreros de candidatos
Put a lawn sign in my yard | Pueden colocar letrero en mi jardín
Telephone calls from headquarters | Haciendo llamadas
Volunteering on Election Day | Ayudando dia de elecciones
Voter Registrations | Registración de votantes
Writing letters to the editor | Escribir cartas a los Periódicos
Click "Submit" button to send
Presione "Submit" para enviar
