Yes No     Would you support an on-line voting process for all state, federal
                           and local elections?

Yes No     Do you believe President Bush is doing a good job with the US military                            efforts in the Middle East?

Yes No     Do you believe the US economy is in a state of recession?

Yes No     Are you afraid to travel on a commercial passenger airline at the moment?

Yes No     Do you believe Osama Bin Laden will be captured?

Yes No     Do you believe there is adequate security at US airports?

Please let us know your thoughts on these issues, or any suggestions for items that you think your representatives should be made aware of.

Yes No     Would you like us to E-Mail you to make you aware when new initiatives come on line?

(If Yes) E:Mail Address:

Thank You!

Optional information will help us to let you know when important issues in your area arise.

Name: *Optional

Address: *Optional

City: *Optional

State: *Optional

ZIP: *Optional