State Budget 2019 Turnout, Postcard & T-shirt Form

1
"I can help with this fight around the state budget public hearings..."* This field is required.NOTE We don't yet know the exact address of these hearings but we believe we know what city and dates, so pledge if you think you might be able to go to one within 60 minutes of you, during the day-time on a week-day.
...by contributing $1 for printing/postage to send a letter to help flood the offices of WI State Senators with mail to urge action on healthcare & fair maps
...by planning on attending with Citizen Action and testifying for under 2 minutes. (you can ask for talking points on a later page)
...by planning on standing in solidarity with those testifying, but I don't want to speak
...I want to learn more about buying a Citizen Action union-made t-shirt for $20 with our state budget healthcare-for-all demands !
...by participating in a "phone/text tree" to keep ~40 people in my area informed of when/where to go if you provide me ~40 names
Other
2
Name* This field is required.
First Name
Last Name
3
Email* This field is required.
example@example.com
4
City* This field is required.
5
Phone Number
Area Code
Phone Number
6
Image FieldOur members will be attending these State budget public hearings in t-shirts with our clear demands for healthcare-for-all and a healthcare system (whether in hospitals, schools or nursing homes) that works for all! Get yours for $20!
7
"I would be able to travel to a "Joint Finance Committee" Public Hearing in one or more of these regions of the state"If others are added we will let you know ASAP, as well as let you know where you can meet up with other Citizen Action members/supporters. NOTE let us know if you think you might be able to attend. We understand you may not 100% know at this moment
Fri April 5th, Janesville (Rock County), Pontiac Convention Center, 2809 N Pontiac Drive
Wed April 10th, Oak Creek (Milwaukee County), OC Community Center, 8580 S Howell Ave
Mon April 15: River Falls (Pierce Co), University of Wisconsin River Falls, University Center - Riverview Ballroom #260, 500 Wild Rose Ave
Wed April 24: Green Bay (Brown Co), UW Green Bay Union, Phoenix Rooms 2430 Campus Court
Wed April 4th, Madison (NOTE, we can only be visible, we cannot testify here), State Capitol
I don't live within an hour of any of these places! (Or I can't make any of these dates work) What can I do?
Other
8
I can't be at these places on these dates, what can I do?We wish the Legislature held these events conveniently for all Wisconsinites, but there is more you can do
Let me know if other locations are added
I can help with a "phone tree" of ~40 people, to tell them by phone or text about these events
I can help send this form to others so they may be able to go
I can contribute $1 for postage/printing to send a letter to Legislators. Tell me how
9
"I can help by... (optional)(Check all that apply)
...dedicate a day to attending a public budget hearing in solidarity with Citizen Action members
...plan on bringing a full car of other people to the event, at least 2-3 more!
...commit to getting at least one other to also pack their car full of people who could attend
...share this form around so others can also pledge to attend! (you'll be redirected after this form)
Other
10
"To be successful at the public hearings I would like from Citizen Action..."
...talking points to make sure I mention the most important issues
...help crafting a 1-2 minute explanation about why I care enough to attend (your "story")
...help with transportation to this event
...someone to come and speak to my local group about this
Other
11
T-Shirt: would you wear a t-shirt with Citizen Action's demands and logo on it so we both can find each other in the crowd and so elected officials can see how many of us there are?Our shirts are blue with our logo on the front, and on the back list four priority issues: (1) BadgerCare expansion, (2) a BadgerCare Public Option, (2) substance use/mental health support in schools, and (4) $15 an hour living wage for direct care workers helping people with disabilities and senior citizens.
No I do not want a t-shirt
Yes, I would like to buy a t-shirt for $20, let me know how (and list your size on the next form!)
Other
12
T-shirt Size (Optional)NOTE! If you would like multiple, please email Kevin.kane@citizenactionwi.org or if you don't want a shirt, just hit "next"
XS
S
M
L
XL
XXL
XXXL
Other
13
(Optional) Send a postcard to the GOP State Senate on BadgerCare expansion and on Fair Maps ($1 for printing and postage)(Pick up to 2) The Senate is the major roadblock to Fair Maps & expanding BadgerCare. These letters will flood Senate offices urging this Legislature to act and informing them that we are organizing as Citizen Action in many of their districts. So either the Legislators say YES to BadgerCare & Fair Maps or we will work to build a moral movement to elect new leaders.
Send to Senate Majority Leader Scott Fitzgerald (Good no matter where you live in WI)
Send to my GOP State Senator (look up my address to determine which Senator)
Send to my GOP State Representative (look up my address to determine which Rep)
(I want to add my own message to the postcard)
Other
14
Type your message to your state legislator here (option)
Huge
Large
Normal
Small
Ok
Ok
15
Sign up to send a postcard to WI State Senators ($1 for postage/printing), or buy a Citizen Action t-shirt ($20), or both ($21)!(Skip this form if you have already purchased a shirt/postcard, or you do not want to purchase one.) NOTE this is a secure payment form
prevnext( X )
1
USD
20
USD
21
USD
Support
USD
+ OR enter a custom value
Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2025
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
Expiration Year
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
16
Almost done! One more question - should we organize more in your area of Wisconsin?We are organizing people in key areas to launch "Organizing Co-ops", critical mass of local members contributing monthly dues of about $20-$30 per month to hire a local organizer. Would you be interested in learning more about how we can build a co-op in your area?
Not at this time
I already am a co-op member, thanks!
I'd be interested in joining ONLY IF we find that critical mass in my area. Let me know!
I will help share this form around so others might also consider joining
Other
Should be Empty: