Ballot Question Volunteer Form Ballot Question Volunteer FormI represent (choose one): Individual Company or Business Group or AssociationFirst NameLast NameCompany or Group Name (If Relevant)EmailPhone Number (Used only to Coordinate)Contact Preferences Phone EmailText Me about Safer Tech I agree to receive key campaign alerts and event invites by automated text from the Massachusetts ballot committee Safer Tech at LastTreeLaws.com number (866) 554-3089. Reply STOP to cancel at any time, HELP for help. This agreement isn't a condition of any purchase. Msg & data rates may apply. Msg frequency varies. Terms at LastTreeLaws.com/text-join/ and Privacy Policy at lasttreelaws.com/privacy-policy-2/ Text Me about Safer Tech I agree to receive key campaign alerts by automated text from the Massachusetts ballot committee Safer Tech at LastTreeLaws.com number (866) 554-3089. Reply STOP to cancel at any time, HELP for help. This agreement isn't a condition of any purchase. Msg & data rates may apply. Msg frequency varies. Terms at LastTreeLaws.com/text-join/ and Privacy Policy at lasttreelaws.com/privacy-policy-2/Best Time to Call (Optional)Town, County- Select -Barnstable*, BarnstableBourne, BarnstableBrewster, BarnstableChatham, BarnstableDennis, BarnstableEastham, BarnstableFalmouth, BarnstableHarwich, BarnstableMashpee, BarnstableOrleans, BarnstableProvincetown, BarnstableSandwich, BarnstableTruro, BarnstableWellfleet, BarnstableYarmouth, BarnstableAdams, Berkshire CountyAlford, Berkshire CountyBecket, Berkshire CountyCheshire, Berkshire CountyClarksburg, Berkshire CountyDalton, Berkshire CountyEgremont, Berkshire CountyFlorida, Berkshire CountyGreat Barrington, Berkshire CountyHancock, Berkshire CountyHinsdale, Berkshire CountyLanesborough, Berkshire CountyLee, Berkshire CountyLenox, Berkshire CountyMonterey, Berkshire CountyMt. Washington, Berkshire CountyNew Ashford, Berkshire CountyNew Marlborough, Berkshire CountyNorth Adams, Berkshire CountyOtis, Berkshire CountyPeru, Berkshire CountyPittsfield*, Berkshire CountyRichmond, Berkshire CountySandisfield, Berkshire CountySavoy, Berkshire CountySheffield, Berkshire CountyStockbridge, Berkshire CountyTyringham, Berkshire CountyWashington, Berkshire CountyWest Stockbridge, Berkshire CountyWilliamstown, Berkshire CountyWindsor, Berkshire CountyAcushnet, Bristol CountyAttleboro, Bristol CountyBerkley, Bristol CountyDartmouth, Bristol CountyDighton, Bristol CountyEaston, Bristol CountyFairhaven, Bristol CountyFall River*, Bristol CountyFreetown, Bristol CountyMansfield, Bristol CountyNew Bedford*, Bristol CountyNorth Attleborough, Bristol CountyNorton, Bristol CountyRaynham, Bristol CountyRehoboth, Bristol CountySeekonk, Bristol CountySomerset, Bristol CountySwansea, Bristol CountyTaunton*, Bristol CountyWestport, Bristol CountyAquinnah, Dukes CountyChilmark, Dukes CountyEdgartown*, Dukes CountyGosnold, Dukes CountyOak Bluffs, Dukes CountyTisbury, Dukes CountyWest Tisbury, Dukes CountyAmesbury, Essex CountyAndover, Essex CountyBeverly, Essex CountyBoxford, Essex CountyDanvers, Essex CountyEssex, Essex CountyGeorgetown, Essex CountyGloucester, Essex CountyGroveland, Essex CountyHamilton, Essex CountyHaverhill, Essex CountyIpswich, Essex CountyLawrence*, Essex CountyLynn, Essex CountyLynnfield, Essex CountyManchester by the Sea, Essex CountyMarblehead, Essex CountyMerrimac, Essex CountyMethuen, Essex CountyMiddleton, Essex CountyNahant, Essex CountyNewbury, Essex CountyNewburyport*, Essex CountyNorth Andover, Essex CountyPeabody, Essex CountyRockport, Essex CountyRowley, Essex CountySalem*, Essex CountySalisbury, Essex CountySaugus, Essex CountySwampscott, Essex CountyTopsfield, Essex CountyWenham, Essex CountyWest Newbury , Essex CountyAshfield, Franklin CountyBernardston, Franklin CountyBuckland, Franklin CountyCharlemont, Franklin CountyColrain, Franklin CountyConway, Franklin CountyDeerfield, Franklin CountyErving, Franklin CountyGill, Franklin CountyGreenfield*, Franklin CountyHawley, Franklin CountyHeath, Franklin CountyLeverett, Franklin CountyLeyden, Franklin CountyMonroe, Franklin CountyMontague, Franklin CountyNew Salem, Franklin CountyNorthfield, Franklin CountyOrange, Franklin CountyRowe, Franklin CountyShelburne, Franklin CountyShutesbury, Franklin CountySunderland, Franklin CountyWarwick, Franklin CountyWendell, Franklin CountyWhately , Franklin CountyAgawam, Hampden CountyBlandford, Hampden CountyBrimfield, Hampden CountyChester, Hampden CountyChicopee, Hampden CountyEast Longmeadow, Hampden CountyGranville, Hampden CountyHampden, Hampden CountyHolland, Hampden CountyHolyoke, Hampden CountyLongmeadow, Hampden CountyLudlow, Hampden CountyMonson, Hampden CountyMontgomery, Hampden CountyPalmer, Hampden CountyRussell, Hampden CountySouthwick, Hampden CountySpringfield*, Hampden CountyTolland, Hampden CountyWales, Hampden CountyWest Springfield, Hampden CountyWestfield, Hampden CountyWilbraham, Hampden CountyAmherst, Hampshire CountyBelchertown, Hampshire CountyChesterfield, Hampshire CountyCummington, Hampshire CountyEasthampton, Hampshire CountyGoshen, Hampshire CountyGranby, Hampshire CountyHadley, Hampshire CountyHatfield, Hampshire CountyHuntington, Hampshire CountyMiddlefield, Hampshire CountyNorthampton*, Hampshire CountyPelham, Hampshire CountyPlainfield, Hampshire CountySouth Hadley, Hampshire CountySouthampton, Hampshire CountyWare, Hampshire CountyWesthampton, Hampshire CountyWilliamsburg, Hampshire CountyWorthington, Hampshire CountyActon, Middlesex CountyArlington, Middlesex CountyAshby, Middlesex CountyAshland, Middlesex CountyAyer, Middlesex CountyBedford, Middlesex CountyBelmont, Middlesex CountyBillerica, Middlesex CountyBoxborough, Middlesex CountyBurlington, Middlesex CountyCambridge*, Middlesex CountyCarlisle, Middlesex CountyChelmsford, Middlesex CountyConcord, Middlesex CountyDracut, Middlesex CountyDunstable, Middlesex CountyEverett, Middlesex CountyFramingham, Middlesex CountyGroton, Middlesex CountyHolliston, Middlesex CountyHopkinton, Middlesex CountyHudson, Middlesex CountyLexington, Middlesex CountyLincoln, Middlesex CountyLittleton, Middlesex CountyLowell*, Middlesex CountyMalden, Middlesex CountyMarlborough, Middlesex CountyMaynard, Middlesex CountyMedford, Middlesex CountyMelrose, Middlesex CountyNatick, Middlesex CountyNewton, Middlesex CountyNorth Reading, Middlesex CountyPepperell, Middlesex CountyReading, Middlesex CountySherborn, Middlesex CountyShirley, Middlesex CountySomerville, Middlesex CountyStoneham, Middlesex CountyStow, Middlesex CountySudbury, Middlesex CountyTewksbury, Middlesex CountyTownsend, Middlesex CountyTyngsborough, Middlesex CountyWakefield, Middlesex CountyWaltham, Middlesex CountyWatertown, Middlesex CountyWayland, Middlesex CountyWestford, Middlesex CountyWeston, Middlesex CountyWilmington, Middlesex CountyWinchester, Middlesex CountyWoburn , Middlesex CountyNantucket*, Nantucket CountyAvon, Norfolk CountyBellingham, Norfolk CountyBraintree, Norfolk CountyBrookline, Norfolk CountyCanton, Norfolk CountyCohasset, Norfolk CountyDedham*, Norfolk CountyDover, Norfolk CountyFoxborough, Norfolk CountyFranklin, Norfolk CountyHolbrook, Norfolk CountyMedfield, Norfolk CountyMedway, Norfolk CountyMillis, Norfolk CountyMilton, Norfolk CountyNeedham, Norfolk CountyNorfolk, Norfolk CountyNorwood, Norfolk CountyPlainville, Norfolk CountyQuincy, Norfolk CountyRandolph, Norfolk CountySharon, Norfolk CountyStoughton, Norfolk CountyWalpole, Norfolk CountyWellesley, Norfolk CountyWestwood, Norfolk CountyWeymouth, Norfolk CountyWrentham, Norfolk CountyAbington, Plymouth CountyBridgewater, Plymouth CountyBrockton*, Plymouth CountyCarver, Plymouth CountyDuxbury, Plymouth CountyEast Bridgewater, Plymouth CountyHalifax, Plymouth CountyHanover, Plymouth CountyHanson, Plymouth CountyHingham, Plymouth CountyHull, Plymouth CountyKingston, Plymouth CountyLakeville, Plymouth CountyMarion, Plymouth CountyMarshfield, Plymouth CountyMattapoisett, Plymouth CountyMiddleborough, Plymouth CountyNorwell, Plymouth CountyPembroke, Plymouth CountyPlymouth*, Plymouth CountyPlympton, Plymouth CountyRochester, Plymouth CountyRockland, Plymouth CountyScituate, Plymouth CountyWareham, Plymouth CountyWest Bridgewater, Plymouth CountyWhitman, Plymouth CountyBoston*, Suffolk CountyChelsea, Suffolk CountyRevere, Suffolk CountyWinthrop, Suffolk CountyAshburnham, Worcester CountyAthol, Worcester CountyAuburn, Worcester CountyBarre, Worcester CountyBerlin, Worcester CountyBlackstone, Worcester CountyBolton, Worcester CountyBoylston, Worcester CountyBrookfield, Worcester CountyCharlton, Worcester CountyClinton, Worcester CountyDouglas, Worcester CountyDudley, Worcester CountyEast Brookfield, Worcester CountyFitchburg*, Worcester CountyGardner, Worcester CountyGrafton, Worcester CountyHardwick, Worcester CountyHarvard, Worcester CountyHolden, Worcester CountyHopedale, Worcester CountyHubbardston, Worcester CountyLancaster, Worcester CountyLeicester, Worcester CountyLeominster, Worcester CountyLunenburg, Worcester CountyMendon, Worcester CountyMilford, Worcester CountyMillbury, Worcester CountyMillville, Worcester CountyNew Braintree, Worcester CountyNorth Brookfield, Worcester CountyNorthborough, Worcester CountyNorthbridge, Worcester CountyOakham, Worcester CountyOxford, Worcester CountyPaxton, Worcester CountyPetersham, Worcester CountyPhillipston, Worcester CountyPrinceton, Worcester CountyRoyalston, Worcester CountyRutland, Worcester CountyShrewsbury, Worcester CountySouthborough, Worcester CountySouthbridge, Worcester CountySpencer, Worcester CountySterling, Worcester CountySturbridge, Worcester CountySutton, Worcester CountyTempleton, Worcester CountyUpton, Worcester CountyUxbridge, Worcester CountyWarren, Worcester CountyWebster, Worcester CountyWest Boylston, Worcester CountyWest Brookfield, Worcester CountyWestborough, Worcester CountyWestminster, Worcester CountyWinchendon, Worcester CountyWorcester* , Worcester CountyStreet Mailing Address (for Petition Material Delivery)Zip CodeI want to: Collect signatures locally Deliver and pick up petitions (High Priority) Be a local drop-off/pick up hub Host a signing event (backyard gathering, house party, or public rally) Write letters or press releases Share campaign info online Testify at hearings Join a local working group Share other skillsPlease describe your event ideas (expected date, location, or guest count)Which other skills would you like to contribute?I wish to: Collect voter signatures Host a petition clipboard at my business/ group List my location publicly online as a signature site Keep my hosting private (Do not list online) Host a dedicated signing event or rally Collect voter signatures actively in the community Offer other in-kind donation (e.g., services, materials)I wish to host a petition or collect signatures for: My Town (Listed on my Address) Nearby Towns (Please List)Nearby TownsPlease share your in-kind donation offer (other than clipboard space):Are you willing to help carpool for events and signature gathering, and have a valid driver's license, insurance, and good driving record? (Optional) Yes, and I can cover the gasoline and mileage. Yes, but I must have gas and mileage reimbursement. Yes, but I can only cover gas and mileage temporarily, and would need to start reimbursement when the campaign has funds.For carpooling, how many extra spaces do you have for people in your car?How do you 'get around' town? Public transit Biking Walking I use my car. I have trouble being mobile or walking. I get a ride from someone else.Do you have a background in medicine, public health, engineering, or scientific research? (Optional) YesWhat is your professional field or title?MD / DO (Physician)RN/ NP/ PA (Nursing & Clinical Staff)MPH / Epidemiologist (Public Health Professional)PhD / Research (Biological, Environmental, or Physical Sciences)Electrical Engineer / Tech Infrastructure SpecialistHolistic Health Practitioner / Wellness EducatorOther / DetailsPlease share details on field: How would you be willing to lend your professional expertise to the campaign? (Check all that apply)Sign an Open Letter: Allow my name and credentials to be listed on a statewide petition coalition list for signature requestsMedia & Public Speaking: Serve as a spokesperson for local news interviews or press releases.Educational Content: Help review or write short, fact-based health brochures for our literature drops.Testify at Hearings: Speak on behalf of the initiative at local town hall meetings or state legislative panels.I am providing information for: The Safer Tech at LastTreeLaws.com Campaign Other potential, future campaigns. Last Tree Laws, L.L.C. (model legislation and other updates)Subscribe to Campaign Updates (Email) YesSubmit Form