Volunteer Application

Salutation:
Name*:
Address*:
Address 2:
City*:
State*:
Zip Code*:
E-Mail Address*:
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:

*Required Field

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