Name: *
Address: *
City: *
State: *
Zip: *
Home Phone: *
Work Phone:
Fax:
Email:
Employer: *
Occupation: *

*Required if making a contribution.
I would like to:
Have a sign in my yard
Volunteer on Election Day
Mail furnished postcards to friends
Make phone calls to voters
Host a gathering for Mayor Hays
Go door to door in your neighborhood
Include my/our names on campaign committee or in endorsement ads
Arrange for Mayor Hays to speak to my club or organization
Make a contribution
  $25  $50  $100  $250  $500  Other:

Contributions are limited to $2,000 per person, per election.

Please click the button above to submit your information. 
Further information about how to contribute will be provided on the next page.