Tell us about your program!
Sign in to Google to save your progress. Learn more
Are you part of an organization offering aid in this moment dealing with COVID-19? Tell us about your program and our team will reach out!
You can also reach out directly to the campaign by emailing Kelly@canningforcongress.com or calling (541) 286-5542‬.
Organization Name *
Point of Contact Name *
Phone Number *
Email *
Service Area (county, city, zipcode) *
What services are you able to provide people in your area?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Canning for Congress. Report Abuse