[Main] [Events] [Bio] [Party] [Issues] [Ask Peg] [Read All About It] [FAQ] [Ridge] [Participate]

SOAR With Us!

We are delighted that you are interested in being a part of the Luksik campaign to Save Our American Rights. If you would, please take a minute or two to fill out our on-line registration form.
To volunteer or be placed on the mailing list, please fill out and submit "Part One."

To make a donation, please fill out and submit "Part Two."

Part One - Volunteers and Mailing List Requests

First Name	Middle Initial
Last Name
Email Address
Registration:
	Eligible to vote in PA?

Please put me on Peg's mailing list! (Optional)

Street1

Street2

City State Zip

Phone

Yes, I think I'd like to volunteer!

[Since we'll need to have the appropriate county volunteer coordinator contact you, please provide the following additional information:]

County
Day Phone with Area Code
Evening Phone with Area Code

I'd like to know more about how I could:
Distribute literature in my community.
Make phone calls to supporters.
Make phone calls to voters the week before the election.
Display a yard sign.
Work at the polls on election day.
Be a precinct captain.
Be a Prayer Partner.

Part Two - Donations

Yes, I want to support Peg financially! Campaigns need financing. You can help by sending your maximum gift, by one of the mechanisms listed below. Remember that the law forbids anonymous donations and corporate checks. Also, a mailing address is required for each donation.

First Name	Middle Initial
Last Name
Street1
Street2
City	State Zip
Phone
Email Address

Please indicate the amount of your investment:

	$ 15 $ 30 $ 50 $100
	Other:

Payment Option:
This form utilizes "secure server" technology to encrypt all information, such as credit card numbers, transmitted between your PC and the Web server.
Please charge my the amount

	Name on card:
	Card Number:
	Expiration:

I the campaign and make my investment by phone.

(800) 801-2027

I a check to the following address:

Luksik Action
P.O. Box 792
Johnstown, PA 15907

[Main] [Events] [Bio] [Party] [Issues] [Interactive] [Read All About It] [FAQ] [Ridge] [Participate]

Website By Transcend Technologies, Inc.
Graphic Design by Leopold Creative Marketing
Problems or suggestions, email Webmaster@Transcend-Tech.com
Entire WebSite ©1998, Luksik Action