How You Can Help

You may fill out the form below and click "Submit" to send it to Gerry or contact him by phone or mail (see menu on the left).
All fields are optional, but please be sure to include your NAME and CONTACT INFORMATION (mailing address, phone, and/or email).

Name:
Address:
Town:   State:   Zip:

Phone:
Best hours to call:

E-Mail:

Please check all that apply. I will:
Pray
Vote in Primary Election
Please note: Voters in the Primary Election must be registered as Republican or "unaffiliated" (independent). Unaffliated voters may affiliate with the Republican party by declaring affiliation when they go to vote. They will then remain registered as Republicans until/unless they go to the County Clerk's office and change their affiliation. (Members of other parties may not change their affiliation at the polls.)

Vote in General Election
Contact others (tell 5 other people)
Put up a sign
Display a bumper sticker
Host/organize a meeting with friends, church, club, business
Financial Contribution - Amount:
  • If over $100 must give occupation and employer's name and address.
  • Corporations are not allowed to contribute.
  • Each person is limited to $200 for the Primary and $200 for the General election.
  • Please make checks payable to "McDaniel for State Representative Committee", c/o Century Business Solutions, 109 West Main, Trinidad, CO 81082
Please indicate other ways you would be willing to help or any comments here: