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   How You Can Help Mac

Your participation is essential to our campaign efforts.  Please check off your interests and availability by completing the form below.

Thank you for your interest in the campaign!

 Contact Information
Mr. or Ms.    
First Name    
Middle Initial     
Last Name       
Street Address     
City     
State & Zip       
Daytime Phone       Call here first
Evening Phone       Call here first
Fax    
E-mail Address      
Occupation     (optional)
Send me campaign updates via email
 Please tell us how you can help   (Check all that apply)
  I'll campaign door-to-door for Mac
  I'll display a Middleton yard sign
  I'll host a Coffee for Mac
  I'll help make telephone calls
  I'll help with bulk mailings
  I'll help at the polls on Election Day
  I'll serve as a Community Captain
 Availability
  Mornings   Afternoons   Evenings
  Saturdays   Sundays   Flexible
 We'd like to hear about your special skills or interests

  
Thanks for your support!

 

Paid for by Supporters of Mac Middleton.  Authority - Earle Knapp, Jr., Treasurer