Save Our Hospital Yard Sign Delivery
Sign up to have a "Save Our Hospital" sign dropped off at your address. Suggested donation via Paypal of 5 dollars. Paypal link: https://www.paypal.com/donate/?hosted_button_id=78Z7S94UQ4B4U
Sign in to Google to save your progress. Learn more
Email *
Name
Address and Notes on Delivery (where to put the sign and anything else we need to know)
Email and/or Phone Number (if you want to be kept in the loop and support our campaign more)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy