Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
What issues of concerns brought you to the MISSOURI de jure Assembly?
What are you most passionate about? What drives you to want to help?
Can you work independently? Are you an organizer, researcher &/or task-oriented?
I am interested in the following committees:
Legal
Security & Safety
Family Services
Project Management
Education & Development
Needs Assessment
Health & Wellness
Nature Preservation, Protection & Enhancement
Treasury
Other
How did you hear about the MISSOURI de jure Assembly?
Are you a member of other assemblies? Name?
Submit
Should be Empty: