* 1. Name (must include for your vote to be tallied; all responses are confidential)

* 2. Are you

* 3. Are you a Republican

* 4. Do you believe that the Log Cabin Republicans should endorse Governor Romney for President?

* 5. Do you plan on voting for Governor Romney even if you do not think the Log Cabin Republicans should publicly endorse him? (Only answer if you voted no on an LCR Endorsement)

* 6. Do you believe that the Michigan Log Cabin Republicans should endorse Former Congressman Pete
Hoekstra for US Senate?

* 7. If you are interested in joining the Michigan Log Cabin Republican email list, please add your email
address below. (all information submitted is confidential)

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