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Volunteer Form

Contact Information:

Name:_________________________________________________________

Home Address:__________________________________________________

City:______________________State:_____________________Zip:________

Phone:_______________________ Email Address:_____________________

Preferred Volunteer Times:

___ 9 am - 1 pm
___ 1 pm - 5 pm
___ 5 pm - 9 pm

___ Weekdays
___ Weekends

Check all that apply

I would like to help with the following:

___ Yard Signs
___ Canvas
___ Phone Calling
___ Mailing
___ All of the Above

Additional Comments:
________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

___ Add me to the email list

Print and mail to:
Nariman for Congress
PO Box 1144
Williamsville New York 14221