Required Fields are marked with (*)
Please provide the following information
* Name:
* Address:
* City:
* State:
* Zip:
Home Phone:
Work Phone:
* e-mail:
I am willing to help in the following ways
Door to Door Canvasing
Phone Banking
Office Work
Data Entry
Host a Fund Raiser
Help with events
March in Parades
Help with Yard Signs
Other
Paid for By Friends of Mary Valentine | P.O. Box 421 | Muskegon MI 49443
