Petition to Support Seniors Form

Petition to Support Seniors Form
Thank you for supporting our cause. Please fill out the form to add your voice to the petition.
Join us in advocating for our senior citizens facing hardship in our town. Let's come together to ensure they receive the support and resources they need for a dignified and comfortable life. Sign now to show your commitment to caring for our elderly residents.
Full Name
First NameLast Name
Signature
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Email Address (Optional)
example@example.com
Phone Number (Optional)
Please enter a valid phone number.
Reason for Supporting Seniors
How do you propose to support seniors in your community?
Do you have any personal experiences or stories related to senior support that you'd like to share?
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