Name
*
First Name
Last Name
Personal Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
*
I support the California Billionaire Tax Act to stop the healthcare collapse
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Which best describes you?
*
Elected Official
Community Organization
Business
Faith Leader
Organization Name
Office Title
Business Name
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Communications (Optional)
We may be able to include the campaign in paid communications (mail, digital, phones)
We plan to distribute a voter guide
Not applicable / unsure
Field & Volunteers (Optional)
We run a field or volunteer program
We could host volunteer nights
We’re open to allowing calls/texts to our lists about volunteer opportunities
Events & Speaking (Optional)
We can connect the campaign with speaking opportunities or events
I / a representative would consider serving as a spokesperson
Ways Businesses Sometimes Support (Optional)
Display a support sign in our window
Allow tabling at our business
Sign onto a small business support letter
Faith Leader Engagement (Optional)
Interested in serving as a spokesperson
Open to the campaign speaking to our congregation
Willing to sign a faith leaders’ support letter
Submit Endorsement
Should be Empty: