Chellie Pingree for Congress:

Please share with me how you've been affected by the economic downturn.

Email: *

First Name:

Last Name:

Address:

City:

State:

Zip / Postal Code: *

Country:

Phone:

What is your #1 concern regarding the economy:
  Cost of food and other essentials
  Price of gasoline and heating oil
  Cost of health care
  Tax fairness
  Saving for college
  Housing costs and mortgage defaults
  Job security
  Retirement security
  Other

What is your #2 concern regarding the economy:
  Cost of food and other essentials
  Price of gasoline and heating oil
  Cost of health care
  Tax fairness
  Saving for college
  Housing costs and mortgage defaults
  Job security
  Retirement security
  Other

What is your #3 concern regarding the economy:
  Cost of food and other essentials
  Price of gasoline and heating oil
  Cost of health care
  Tax fairness
  Saving for college
  Housing costs and mortgage defaults
  Job security
  Retirement security
  Other

Comments:

Please tell me about yourself.

What age group do you belong to:
  under 18
  18 - 25
  26 - 35
  36 - 45
  46 - 55
  56 - 65
  66 - 75
  over 75

Do you have children living at home:
Yes
No

Are you a registered:
  Democrat
  Republican
  Independent (called "Unenrolled" in Maine)
  Green
  None of the above

* denotes required field

Thanks for participating in the poll.

Reach us directly:

P.O. Box 17613
Portland, Maine 04112

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