Join Jeremy's Campaign

Please answer all of the questions below. If you have any further comments, email me directly. The contact information is available by clicking the 'contact' button on the right hand side. Thank you!

1. Name
2. Email Contact
3. What type of volunteer work are you willing to do?
4. When can you work?
5. If you can work more than shift than provided in the above question, please type out the other shifts.

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