Participation Questionnaire

We want to know which organizations our members are active in, where we can link people together and have discussions about politics and state workers. We want to engage leaders in other organizations to help lobby legislators or local media about the important work that state workers do.

Political Questionnaire

Please fill out the form below

Name

Title

First Name *

Last Name *

Suffix

DLC

'DLC' is required

Worksite

'Worksite' is required

Department

'Department' is required

Work Phone

- ###

####

Home Phone

- ###

####

Cell Phone

- ###

####

Address

Address 1

Address 2

City

State

Postal Code

Country

E-mail

@ *

Do you belong to a religious organization?

Yes
No

If yes Name of Organization

'If yes Name of Organization' is required

Do you or someone in your family belong to a business association, such as rotary club, Lion’s Club, camber of commerce?

Yes
No