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First Name
Last Name/M.I.
Title/Position
Campaign/
Organization




Address

 

City/State/Zip


 

 

Telephone/Fax

E-Mail

 

 


 

Which communications tools interest you?
Whichof the following voter contact services interest you? (Check all that apply.)

Direct Connect/Patch Through Calls Will Calls Activist Recruitment Calls Membership Recruitment Calls Volunteer Recruitment Calls

Personal Letter Writing Programs Post Card Campaigns FAX Campaigns Fundraising

 

What level is this grassroots program?
Desired start date?
What is the Universe size?
If this is a telephone program, in which time zone(s) would we be calling?
(Check all that apply)

 

Eastern Central Mountain Pacific

 

If this is a telephone program, would we be calling?
(Check all that apply)

 

Residential Telephone Numbers Business Telephone Numbers

 

Comments:

 

 

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