Contact/Participation Form 

       - Subscribe for Updates, News, and Notices 
       - Participation Opportunities 
       - Questionnaire 
       - Suggestion Box for Comments and Questions 
       - Donations 

Thanks for responding.  For responses, updates, etc., we need a way to contact you.  Additional info (optional) helps us better serve you.
Contact Information:  for Responses, Updates, News, and Notices 
Street Address:
City:      Zip: 
Best way to contact me:Email Post Fax Phone
Please keep me informed with: 
Weekly Updates Notices of major updates and breaking news as they occur 
Political Party:Democrat Republican    Other: Not Registered 
County:     Municipality:    Ward:     Voter Dist.: 
Participation Opportunities 
Would you like to help PANDA? Yes Maybe No
Things I might like to do to help PANDA? 
Website maintenance Graphic arts and material prep. Phone Polling 
Line up speaking engagements, etc. Office management and tasks. 
Writing - position papers, letters to newspapers, etc. Research, etc.
Speaking - presentations, events, etc. 
  Campain Assistance: 
Collect candidate petition signatures (to place names on the ballot) 
Putting up signs Working polls on election day, etc. 
  Other Help: 
Do you agree with the present direction of southwestern Pennsylvania's leadership? 
Completely Mostly Somewhat Not Much Definitely Not
How likely are you to vote in the coming election? 
Definitely will Probably will Unsure Unlikely Will not
Would knowing of local candidates who support the PANDA platform make you more 
likely to vote in the coming election? Definitely Probably No Difference
Are you running for office? Yes Strongly Considering 50-50 
Wish I could, but probably won't Definitely Not 
Does having the option of the PANDA platform make it more likely you might run 
for county or municipal office? Yes No
Are you working with a campaign? 
Yes Plan to No plans yet, but willing to No and won't
Suggestion Box for Comments and Questions 
For a response, leave contact info above
Financial contributions and in-kind donations may be made to PANDA.
Check donations may be sent to:

720 Allegheny Building
429 Forbes Avenue
Pittsburgh, PA 15219

For more information call:   412-343-6177   
- or -
    FAX:  412-765-2704

Or email us at:  pandapage@comcast.netauto-email to PANDA

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