Rep Reick's Stay at Home Survey

Rep Reick's Stay at Home Survey

Do you agree with the Governor's modified stay at home order?

Agree Strongly

Agree Somewhat

Disagree Somewhat

Disagree Strongly

Don't Know/Need More Information

First Name

Last Name

Email

Mobile phone (optional)

Send me email updates

Send me text messages

Address (Street, City, State, Postal code)

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