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Democratic District -B- Committee | |
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DISTRICT ~B~ COMMITTEE SOUTH NORWALK, CT OFFICIAL SITE Joe Newell, Chairman Robert Burgess, Vice-Chair Al Ayme, Secretary Mary R. Geake, Corresponding Secretary Mike Geake, Treasurer We appreciate your contributions. Please send contributions payable to: DEMOCRATIC DISTRICT ~B~ COMMITTEE ~click here~ MAILING LIST 2nd TAXING DISTRICT STREET MAP OF SOUTH NORWALK |
     VOLUNTEER to join our team of members and government officials. You can make a difference. We are glad to hear from Norwalk residents with their ideas, suggestions and/or concerns, and those who recognize the importance of engaging dynamic participation in the political process. ~click here~ |
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| First Name | Nombre: * | |
| Last Name | Apellido: * | |
| City | Ciudad: * | |
| Zip Code | Código Postal: * |
If you Select "Other" enter your zip code below Si selecciona "Otro" indique su Código Postal abajo. |
| Other Zip Code Otro Código Postal: * |
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| E-mail | Dirección Electrónica:
*
(Example:edwards@gmail.com) | (Ejemplo:josé@gmail.com) |
Should be a valid e-mail address | E-mail válido |
| Verify E-mail | Verifique dirección electrónica: * |
Should match the e-mail address you provided above | Debe ser dirección electrónica igual a la anterior |
| Cell Phone | Celular: * | |
| Home Phone | Teléfono: * | |
| Work Phone Teléfono Trabajo: * |
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| Fax | Facsimile: * | |
| Preferred Contact | Forma de Contacto: | Email Cell Phone Home Phone Fax |
| Volunteer | Voluntario (Check all that apply | Marca una ó más.) I would help by performing the following tasks | Yo ayudaré cooperando con los siguientes trabajos: | Driving Voters to the polls Flyers and campaign material distribution, door to door Mailings from Headquarters Placing yard signs Telephone calls from headquarters Volunteering on Election Day Voter Registrations Writing letters to the editor |
| Write any notes or message, suggestions, recommendations, comments, any information you'd like to
provide or receive from us. Escriba aqui sus notas, mensaje, sugerencias, recomendaciones, comentarios, información que Usted desea enviarnos ó recibir de nosotros. |
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Click "Submit" button to send Presione "Submit" para enviar | |