- Yes - No I have participated in at least 20 hours of POWER activities in the last two years. Some of the POWER activities I have taken part in include (check all that apply):

I did this	I want to do this
		Read POWER newsletters.
		Contacted legislators.
		Attended weekly or monthly volunteer meetings.
		Spoke publicly at an event, hearing, forum, meeting.
		Was a Welfare Witness.
		Helped with fundraising activities like art shows, fund drives, grants.
		Provided outreach at my local welfare office.
		Represented POWER at a community meeting, event or on a committee.
		Helped with office work (clerical, computers, phones, mailings).
		Worked on media relations (letter to the editor, photos, article, radio show).

POWER will not share your personal information with anyone without your written consent.

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Address:

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I am receiving POWER updates: - Yes - No

If no, the best way to reach me is: - email - phone - mail

My work with POWER benefited my family or me in these ways.

POWER is great because:

These suggestions might improve POWER: