Name:
Address:
City:
State:
ZIP:
Phone:
Email:
Comments:
I would like to stay informed and receive important emails.
Please contact me about having Jim Harrell attend or speak at an event.
I would like to display a yard sign in support.
I am interested in volunteering (please check all that apply):
Making telephone calls.
Meeting neighbors door-to-door.
I would like to host a gathering with my neighbors for Jim to attend.
Delivering yard signs in my neighborhood.
I have other skills I'd like to use to help with the campaign (artisit, musician, clerical, technical, creative, etc.)
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