We the undersigned registered voters hereby petition for an election on the following question: 'Are you in favor of the sale of alcoholic beverages within Madison County, Kentucky?'
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birth date
*
.
Today's date
*
.
Signature
*
Submit
Should be Empty: