Form

A statewide campaign is a huge undertaking. I can't do this without the help of a lot of friends. Thanks for your willingness to help. Please fill out the items listed below, and check all the boxes that apply to you. We will get back to you as soon as we can.

First Name:*

Last Name:*

City:*

E-mail:*

Phone:*

I want to help!*

I am endorsing Jim I will make phone calls for Jim I will send e-mails for Jim I will host a reception or coffee I will display a yard sign I will display a bumper sticker I will volunteer for the campaign (please list activities in comments box)

Comments:

Additionally, you can click here to send me an email.