Bill Adolph State Representative

Yes Bill, I want to help you during your re-election Campaign.

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Address 1:*

Address 2 :

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Work Phone :

Cell Phone :

Fax :

Email:*

Best way to contact you (check all that apply):

Cell Phone

Home Phone

Work Phone

Mail (Home Address)

Best time to contact you. (check all that apply):

Anytime Mornings Evenings Weekends

Thank you for offering your assistance to my campaign. If you can help with any of the efforts below, please check all the appropriate boxes.

Deliver signs

Put up a lawn sign at my home or office

Serve on a host committee

Host an event at my house

Arrange a speaking event for Bill

Work the polls on Election Day

Make phone calls

Help raise funds for Bill's campaign

Other: