Want to contribute to change? Submit your information to assist with our startup efforts, or to be considered for our National Team, Board, or Advisory Board!

 

Name *
Name
they/them/Mx., she/her/Ms., he/him/Mr., etc.
I'm interested in *
Have you been diagnosed with tick-borne disease(s)? *
Has a family member or close friend been diagnosed with TBDs? *
Specify you relevant skills. i.e.; social media production, public relations, political communications, public speaking, fundraising, etc.
Include volunteer or professional experience that relates to your interests in joining us at Simple Politicks. Please include role and length of time for each experience specified.
Address
Address
 

Note: We are in the process of becoming an incorporation, and will then apply for 501(c)(3) status. If you submit this form indicating your interest in contributing to startup efforts, we will be in touch immediately. If you submit this form indicating your interest in joining the Team, Board, or Advisory Board, we will contact you once we've completed our articles of incorporation.