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* 1. Your information

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* 2. May we send you text messages with event and meeting info? (These will
be very infrequent and only for important events)

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* 3. Are you a new member or are you renewing your membership?

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* 4. Are you a member of the Michigan Democratic Party?

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* 5. If you answered "No" to #4, please go to www.michigandems.com and join
the MDP! Membership is required for participation in conventions.

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* 6. *Optional* If you feel comfortable answering, do you currently live with a 
disability?

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* 7. *Optional* If you answered yes above, and feel comfortable doing so, please
let us know about your disability and any accommodation you would need to participate in caucus or party events.

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* 8. Are there any pressing issues you would like to see the Disability Caucus
work on? If Yes, please provide information below.

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* 9. Would you be interested in representing your district on the caucus executive board? (We are seeking 2 members from each district of differing genders)

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* 10. Do you have any additional comments or info for us?

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