Yard Sign Request Form
Please Note: We are only able to deliver signs within the 27 counties of the Second District.
Full Name
*
First Name
Last Name
Phone Number
*
E-mail
*
example@example.com
Street Address
*
Please enter the physical address where you would like your sign delivered.
City
*
County
*
Please Select
Allen
Atchison
Bourbon
Brown
Chase
Cherokee
Coffey
Crawford
Doniphan
Douglas
Geary
Jackson
Labette
Leavenworth
Linn
Lyon
Marion
Montgomery
Morris
Nemaha
Neosho
Osage
Shawnee
Wabaunsee
Wilson
Woodson
Wyandotte
How would you like your sign delivered?
*
Deliver to the door
Install the sign at the curb (Note: we are not responsible for any damage to sprinklers, invisible pet fences, etc.)
Other
Additional comments:
i.e. Number of signs requested, other locations you would like them delivered, etc.
Please verify that you are human
*
Submit
PAID FOR BY DEREK SCHMIDT FOR CONGRESS, INC.
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