SIGN UP SHEET FOR TEA PARTY PATRIOTS BUMPER STICKER DAYS

With your permission, you will be added to your Local Tea Party and/or National Tea Party Patriots email lists. Your information will
not be sold or used for any other purpose.
Name ____________________________________ Address
___________________________________________________________________________
City ____________________________________________ State _________ Zip ___________________ Home
#_________________________________
E-mail _______________________________________ Cell #_______________________________ May we TEXT your cell
phone? (Y/N) ____________
May we add your info and email to the Local TPP list? (Y/N) _______ May we add your info and email to
the National TPP list? (Y/N) _____________
Name _____________________________________ Address
__________________________________________________________________________
City ____________________________________________ State _________ Zip ___________________ Home #
________________________________
E-mail _______________________________________ Cell # _______________________________ May we TEXT your cell
phone? (Y/N) __________
May we add your info and email to the Local TPP list? (Y/N) _______ May we add your info and email to
the National TPP list? (Y/N) _____________

Name ____________________________________ Address

___________________________________________________________________________
City ____________________________________________ State _________ Zip ___________________ Home
#________________________________
E-mail _______________________________________ Cell #_______________________________ May we TEXT your cell
phone? (Y/N) ___________
May we add your info and email to the Local TPP list? (Y/N) _______ May we add your info and email to
the National TPP list? (Y/N) ____________

Name ____________________________________ Address

___________________________________________________________________________
City ____________________________________________ State _________ Zip ___________________ Home #
________________________________
Scan and email completed forms to websupport@teapartypatriots.org or fax to Tea Party Patriots National Coordinator Team at 678-302-5377.

E-mail _______________________________________ Cell # _______________________________ May we TEXT your cell

phone? (Y/N) _________
May we add your info and email to the Local TPP list? (Y/N) _______ May we add your info and email to
the National TPP list? (Y/N) ____________

Name ____________________________________ Address

___________________________________________________________________________
City ____________________________________________ State _________ Zip ___________________ Home #
________________________________
E-mail _______________________________________ Cell #_______________________________ May we TEXT your cell
phone? (Y/N) _________
May we add your info and email to the Local TPP list? (Y/N) _______ May we add your info and email to
the National TPP list? (Y/N) ____________

Scan and email completed forms to websupport@teapartypatriots.org or fax to Tea Party Patriots National Coordinator Team at 678-302-5377.