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Username:

Username: Your username will only be used when you login to the website. It will not be displayed to the public, but we recommend you use your real name so it's easy for you to remember.

Password:
Re-Type:


Password: Please select a password from 5-20 characters long. Then re-type the same password in the second field.

Email:
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Email: Please enter your email address and then re-type it in the second field.

PERSONAL INFORMATION

First Name:

First Name: Please enter your first name.

Last Name:

Last Name: Please enter your last name.

Street Address: Street Address: Please enter your street address.
City: City: Please enter your city.
State: State: Please indicate the state of which you are a resident.
Zip: Zip: Please enter your zip code.
Phone: Phone: Please enter your phone number. Optional
VOLUNTEER OPTIONS
Please check any items that interest you, or that you
are willing to help with as a volunteer.

Interests - Candidate Support
Interests - Caucus and Assembly
Interests - Events, Parades, Fundraisers
Interests - Host a Meet and Greet
Interests - Make phone calls
Interests - Polling and Surveys
Interests - Post signs
Interests - Sign Waving
Interests - Social Media
Interests - Voter Registration
Interests - Walk precincts
Interests - Work in the office
Interests - Writing and Research
Lead - Be a precinct or district captain
Lead - Coodinate booths, parades
Lead - Fill open board position
Lead - Run for office
Skills - A/V and other equipment
Skills - Computers
Skills - Finances
Skills - Photography

Volunteer other interests, skills, particular expertise, or suggestions: