Endorsement & Volunteer Form
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Endorsment
*
I support Pat Malone for re-election to the Benton County Board of Commissioners
Please select your area of residence
*
Please Select
Adair Village
Alsea
Bellfountain
Blodgett
Corvallis
Kings Valley
Monroe
North Albany
Philomath
Summit
Other Rural Benton County Community (please list in Notes at the end)
Outside Benton County
Do you consent to have your endorsement of Pat listed on his website?
*
Yes, I consent to have my endorsement of Pat listed on his website
No, I do not wish for my endorsement of Pat to be listed on his website
Would you like to hear more about ways to help Pat win?
*
Yes, I would like to join the mailing list
Yes, I would like to volunteer
Not Right Now
What type of volunteer activities are you interested in?
Talking to your neighbors about Pat's campaign
Making phone calls
Attending events
Writing a letter to the editor
Other
Any Additional Messages or Notes for Pat:
Submit Form
Should be Empty: