Your email*

Phone Number

First and Last Name*

What group(s) or organization(s) do you represent?*

What is your position within that group?

What is the best way to reach you?

Phone

Text

Email

Other

We will be discussing strategies to create a more cohesive and cooperative climate for political groups to be more impactful. At this point, we do not want our plans broadcast to people and groups who are not involved in this effort. Will you agree to keep our initial discussions confidential:? *

Yes

No

Other

Do you agree to not share the access code to this Zoom meeting? *

Yes

No

We are trying to get as many recognized liberty groups and organziations involved as possible. Are there any groups that we might have missed? If so, please include their names and contact information. *

When you have completed this form, I will send you the access code for the Zoom call. Will there a be a problem sending this information by email? If so, please tell me how you would like to get this information? *

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