Sign Up To Be A Supporter/Receive Materials

Yes. I want to add my name as a supporter or be a participant in the Restore Balance West Virginia initiative. I want West Virginia to change its “out of step” ways and to restore balance so we can grow jobs and enhance business success.

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First Name*                        Last Name*

Email Address*

Company

Business Mailing Address

City                              State                            Zip

Phone

WV County


Contact me so I can provide a contribution to the Restore Balance WV education fund.

 Contact me. I'd like to:

            Write letters to the editors of my local newspaper

            Arrange for a speaker at an upcoming event

            Send Restore Balance information to my local legislative candidates

            Organize events in my area

            Tell 3-5 other key individuals in my community about this initiative

            Receive signs for my business      Quantity       

            Receive bumper stickers               Quantity

            Other
                            (Please indicate other things you need or other activities you would like to do with Restore Balance.)

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West Virginia Chamber of Commerce
P.O. Box 2789, Charleston, W.Va.  25301    (304) 342-1115
Copyright 2005