GoodeNews E-Newsletter Request Form



If you would like to sign up to receive Congressman Goode's weekly
Newsletter, GoodeNews, by email please fill out, print and sign
the request form below and send it to the following address:

	Congressman Virgil H. Goode, Jr. GOODENEWS Request
	Attn:  Linwood Duncan
	437 Main Street
	Danville, VA 24541
	Fax:  (434) 797-5942



Name:	________________________________________________

Mailing Address:	________________________________________________

____________________________________________________________________

Email Address:	________________________________________________

With this request, I authorize the Office of Congressman Virgil H. Goode, Jr.
to send the weekly GoodeNews Newsletter to the email address
that I have provided above.

Signature:	______________________________    Date:___________________