Survey

Yes! I will attend Lobby Day to urge legislators to protect patients and the healthcare programs we're counting on.

Thursday, February 11, 2010
8:30 am

United Churches Social Hall
110 11th Avenue SE, Olympia

Buses will be available from Renton.

*
1. Please complete the information below to RSVP for Lobby Day.

Please complete the information below to RSVP for Lobby Day. First Name:
Last Name:
Email Address:
Phone Number:

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2. Please select your workplace from the list:

	Workplace:
Select from the list at right.	Please select your workplace from the list: Select from the list at right. Workplace:

If you selected 'other', please specify:

3. I am interested in more information about taking the bus to Olympia.

I am interested in more information about taking the bus to Olympia. Yes

*1. Please complete the information below to RSVP for Lobby Day.

*2. Please select your workplace from the list:

3. I am interested in more information about taking the bus to Olympia.

*
1. Please complete the information below to RSVP for Lobby Day.

*
2. Please select your workplace from the list: