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Phone Bank Volunteer Form

YES. Please sign me up to be a DC 37 Political Action and Legislation Phone Bank Volunteer.

Print and mail coupon to: District Council 37
Political Action and Legislation
125 Barclay Street, Room 408
New York, NY 10007
Or Fax Coupon to (212) 815-1553

Last Name ________________________ First Name_______________________

Address __________________________________________ Apt. # ___________

City ________________________ State _________ Zip Code ________________

Home Phone ( ____ ) _______________ Work Phone ( ____ ) _______________

E-mail ____________________________ Cell Phone ( ___ ) _________________

Work Schedule: Days ___________ Hours: From ___________ To ____________

Job Title _____________________________ Local ________________________

Agency ___________________________________________________________

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