First name:*
Last name:*
Address:
City:*	State:   Zip:
Email address:
Phone:

* Required fields. Either phone or email is required.

I am interested in volunteering:
daytime
evenings
weekends

Would you like to register voters?
Would you like to do phone volunteers?
Would you like to help with mailings?
Would you like to do walk a precinct or your neighborhood with Ann-Marie?
Would you like to invite Ann-Marie to speak to a group?
Other?