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Pennsylvania Education Advocacy Network A Project of The Education Policy and Leadership Center VOLUNTEER APPLICATION Date: Mr. Mrs. Ms. Dr. Name: Address: Address 2: City: State: please select one Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zipcode: Email Address: Home Phone Number: Cell Phone Number: My County: My State House District: My State Senate District: My School District: I would like to volunteer to serve on the Education Advocacy Team in my: State House District   State Senate District   Either My State Representative Knows Me: Yes No My State Senator Knows Me: Yes No I hold an elected public office: Yes No I hold an appointed public office: Yes No I hold a political party position: Yes No As a volunteer member of an Education Advocacy Team, I can make a contribution to informing my legislator and others about the following issue area(s): Early Education/Pre-K K-12 Education Career Education Special Education College/University Education Other Post-Secondary Education Libraries Adult Literacy Arts Programs and/or Arts Education Public Museums As a volunteer member of an Education Advocacy Team, I would reflect the perspective(s) of: Parent Leader High School Student College Student Professional Staff: education and related organizations Volunteer Board Member: education and related organizations Volunteer Advocate Other Employer: Position: Significant Organizations to which I belong: Other Experience I have that would make me an effective member of the Education Advocacy Team in my legislative district: