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* 1. Name

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* 2. Address

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* 3. City and Zip Code

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* 4. County

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* 5. Email

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* 6. Best phone number to be reached

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* 7. If this is your cell, may we send you texts to update you when applicable for reminders, meetings, etc.? This feature will be used only when needed.

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* 8. Please list your AL State House of Representative member name or your AL House of Rep District if you know either. If not sure, type Not Sure.

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* 9. Please list your AL Senator member name of your AL Senate District if you know either. If not sure, type Not Sure. 

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* 10. What ROAM plans are you interested in participating in when your schedule allows? 

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