* 1. Contact Information

* 2. Which of the following political activities are you interested in participating in? (Select all that apply).

* 3. Which elections would you like to be involved with?

* 4. Are there any specific candidates you’d like to work with?  If so, which ones?

* 5. Have you participated in political work with the local before?
     If so, what do you think worked well?
     What do you think we could do differently this year?