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First Name
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Last Name
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Email Address
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ZIP Code
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Street Address
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Would you like to receive a yard sign?
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We will deliver these at a future date.
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Yes, please install at my home.
Yes, please contact me for other delivery info.
No, thank you.
Will you host a coffee or meet-n-greet for your neighbors or club?
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Yes, please contact me about a coffee.
Not at this time.
No, but I have another idea. Please contact me.
Will you volunteer to greet voters during early voting?
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Yes, please contact me.
Maybe, but you can contact me.
No, thank you.
Please list me on John's Supporter webpage!
If YES, please enter the name as it should appear on the site. For example: "John & Jane Doe" or "Dr. Bill Smith"
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Would you like to share a remark about John that we can use in our campaign efforts?
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