Volunteer Questionnaire

Please note that the Name and Email Address fields below are required.
Your Name (required):
Street Address:
City, State, and Zip Code:
Daytime Phone Number:
Evening Phone Number:
Email Address (required):
I'm a member of:
Are you registered to vote? Yes No
Are you registered to vote as a Libertarian? Yes No
Approximately how many hours per week do you expect to be able to help with the campaign? Less than 2
Between 2 and 10
Between 10 and 40
40 or more
Would you like to subscribe to the Kubby-Volunteer email list?
(This is a high-volume email list for alerts and information about volunteer projects. To subscribe to the lower-volume Kubby-Announce list, please scroll down to the form below.)
Yes No
What experience, skills, talents, or other assets do you have that might help Steve's campaign?


 Kubby Defense Fund
Monarch Bay Plaza, Box 375
Dana Point, Ca 92629-3424

Web: http://www.kubby.com | Email: steve@kubby.org

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