Volunteer and Voice Your Concerns

Complete this form if you want to volunteer to help in the campaign, be placed on our mailing list, would like Moses to speak to your group or if you would like to voice your concerns about specific issues.

First Name:

Last Name:

Title:

Occupation:

Organization:

Address:

City:

State:

Zip:

Phone:

Fax:

Email:

Web Site:

Mailing List, Volunteer:

Please put me on the mailing list.
I want Moses Carey to speak to my organization or church.

I want to volunteer to help. Count on me to: (check all that apply)
	Send postcards to my friends.	Make phone calls for Moses.
	Make a financial contribution.	Allow name in endorsement ad.
	Help raise money.	Have a social event for friends and Moses.
	Put a sign in my yard.	Distribute literature in my neighborhood.
	Pass out brochures at polls on election day.	Sign an endorsement letter.

I have useful contacts in the following group(s)

Issues:

I think your 2008 campaign should stress these issues: (check all that apply)
	Support and incentives for affordable housing.	Incentives for jobs creation and economic development.
	Environmental resource protection.	Health and human services program support.
	Adequate support for public schools.	Fair and efficient criminal justice system.
	Support for Parks & Recreation Land.	Adequate / sustainable support for community colleges / university system.

Other Issues
or Comments:

Graphics, layout and banners Hyers Design hyersdesign.com

Contact the Webmaster