Political Action Network

Please complete the following form to indicate your relationship with state legislators. We will keep on file and reach out to you to encourage interaction with your network for OFDA grassroot efforts:
First Name
Last Name
Funeral Home
Legislator Name
Legislative District
Additional contacts:
Legislator Name
Legislative District
Legislator Name
Legislative District
Please indicate any comments that will help OFDA build its network:
 
   - denotes required fields