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Please provide the following contact information:

First Name
Last Name
Organization
Work Phone
Home Phone
FAX
E-mail
URL

Select any of the following options that apply:

Participate In Town Hall Meetings  Participate in Community Rallys    Host a Meet - N - Greet            Sign Petition Cards              
Pass Out Campaign Materials        Make Phone Calls                   Precinct Walking                   Voter Registration Drives        
Put Out Yard Signs                 Put Our Road Signs                 Sign Waving                        

Would you like Joseph to speak at your church, group or organization? PLEASE provide the information below.