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User account

User Registration Guidelines: Please fill out this form to register. Your application will be sent to a site administrator who must approve your application before your registration is complete. Keep an eye out for your approval email and please be sure to add our domain to you approved addresses in any spam filtering program you may use.

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Newsletter Subscriptions

Picture

Upload picture:

Your virtual face or picture. Maximum dimensions are 85x85 and the maximum size is 300 kB. Please make sure that your picture is no more than 85 x 85 pixels in size.

Personal information

Salutation:

How should we address you?

First Name:

Last Name: *

We need your name, so we know who we're talking to and so the politicians know who we are speaking for.

Street Address:

While it is not required, your street address will help us connect you with the legislators representing your Congressional, Delegate and State Senate Districts. The content of this field is kept private and will not be shown publicly.

City: *

We need this to assign the correct legislative districts. Legislators need to know how many of their constituents stand up for animals. The content of this field is kept private and will not be shown publicly.

State: *

Nearby states are shown before a complete alphabetical list of states. We need this information to assign the correct legislative districts. Legislators need to know how many of their constituents stand up for animals. The content of this field is kept private and will not be shown publicly.

ZIP Code: *

Phone Number:

This will only be used to contact you for the most urgent needs, like an emergency phone campaign to support a piece of humane legislation. The content of this field is kept private and will not be shown publicly.

I am available to help promote humane legislation in Maryland

Let us know if we can contact you when help is needed. The content of this field is kept private and will not be shown publicly.

Please keep me up to date on developments in humane legislation and Maryland Votes for Animals

Please let us know if it is OK to contact you regarding the issues that matter to us. The content of this field is kept private and will not be shown publicly.

Your Passions:

What are the issues that interest you most?

U.S. Congressional District:

If you know your Congressional District, enter it here. This will help us to focus our efforts on your representative. Need help? Click: Find your Elected Officials. The content of this field is kept private and will not be shown publicly.

MD State Senate District:

If you know your MD State Senate District, enter it here. This will help us to focus our efforts on your State Senator. Need help? Click: Find your Elected Officials. The content of this field is kept private and will not be shown publicly.

MD House of Delegates District:

If you know your MD House of Delegates District, enter it here. This will help us to focus our efforts on your State Delegate. Need help? Click: Find your Elected Officials. The content of this field is kept private and will not be shown publicly.

Registration Site:

How did you hear about us? Did you meet us at an event? List it here. Put each item on a separate line or separate them by commas. No HTML allowed. The content of this field is kept private and will not be shown publicly.

Other Associations:

Please let us know what other, related organizations you belong to. You can add a new organization the list and you can select multiple organizations by Ctrl-clicking your choices. Put each item on a separate line or separate them by commas. No HTML allowed. The content of this field is kept private and will not be shown publicly.

Other Comments:

Anything else you'd like to note? The content of this field is kept private and will not be shown publicly.

Word verification: * Type the characters you see in this picture.