Dems Volunteer Form 1 Survey

This form is used to volunteer for working at the Democrats Head Quarters in an effort to "Keep the doors open" to all Democrats in Fairfield County. Please provide us with your contact information here and then select dates and times you can cover the HQ. Name:
Address:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

	Yes	No
9/25	*Are you available on a Saturday from 10 to 12noon? Please select the dates and times your are able to work: 9/25 Yes	9/25 No
10/2	10/2 Yes	10/2 No
10/9	10/9 Yes	10/9 No
10/16	10/16 Yes	10/16 No
10/23	10/23 Yes	10/23 No
10/30	10/30 Yes	10/30 No

	Yes	No	Maybe
9/22	*Can you work on our phone banking efforts on Wednesday evenings from 6pm to 9pm? 9/22 Yes	9/22 No	9/22 Maybe
9/29	9/29 Yes	9/29 No	9/29 Maybe
10/6	10/6 Yes	10/6 No	10/6 Maybe
10/13	10/13 Yes	10/13 No	10/13 Maybe
10/20	10/20 Yes	10/20 No	10/20 Maybe
10/27	10/27 Yes	10/27 No	10/27 Maybe

Dems Volunteer Form 1
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