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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? Mail Telephone Internet All Which of the following voter contact services interest you? (Check all that apply.) Volunteer Recruitment Sensitizing Identification Absentee Ballot Persuasion Promise Get-Out-the-Vote (GOTV) Pre-recorded Get-Out-the-Vote Calls (GOTV) Get-Out-the-Vote (GOTV) Election Day   When is the Election? Select A Month January February March April May June July August September October November December Select A Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 What type of Election is this? Select One Primary Election General Election Special Election Runoff Election Desired start date? In which time zones(s) would we be calling? (check all that apply.)   Eastern Central Mountain Pacific   Which languages pertain to your program? English Only Spanish Only Bilingual (English and Spanish) Other What is the Universe size? Is your Universe already housholded? Yes No Unknown How many records have telephone numbers? In which of the following ranges does your budget fall? Less than $5,000 $5,000 - $25,000 $25,000 - $50,000 $50,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $500,000 - $750,000 $750,000 - $1,000,000 $1,000,000+ Comments:   Contact us at sales@theclintongroup.com or call us directly @ (352) 371-5888