Name                     Office  

Address                        Municipality     Select one Town of Arcade Village of Arcade Town of Concord Village of Delevan Town of Holland Town of Machias Town of Sardinia Village of Springville Town of Yorkshire

Phone               

Email                

Website            www.

Party Affiliation and endorsements

Biographical Information:  Text may be typed directly in the form, or composed with Microsoft Work and inserted using cut and paste.

Your Message:

Links to additional sites: 

Site 1     Name    Web address:    www.

Site 2     Name     Web address:   www.

Email options:  (if you choose to use a hometic.com email box, it will replace the email address listed in your contact information above.

         I do not need  a mail box

         I  want a hometic.com email address which automatically forwards mail to the email address listed in my contact information above.

         Please provide a hometic.com mail box that enables me to send and receive email. (You will be notified by email of the assigned user name, password, and instructions to access mail)

    User Name requested:      (up to 20 characters/numbers) 

Your Picture        To include a picture on your site, send a digital image (in JPEG or BITMAT format)  as an attachment to an email to  ElectionsSupport@hometic.com. Please include candidate name and "candidate homepage"; in the email text.. Your site will be published when your check for $75 is received.  Mail to: HomeTown Webs, 12450 West Schutt Road, Chaffee, NY  14030

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