Citizen's Initiative Review Panelist Application

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Returning this questionnaire makes you eligible to be selected as on of the 18 members of the California Citizen's Initiative Review Demonstration Project held from March 5-7, 2017.

***Demographic Information is kept confidential*** It is being collected to ensure that the citizen panel reflects California's population.

Email *

Name *

Street Address *

Phone *

Gender *

Age *

Can you participate March 5 - 7? *

Yes

Race/Ethnicity (please check all that apply) *

Asian or Pacific Islander

Black

Hispanic or Latino

Native American or Alaska Native

White (not Hispanic or Latino)

Required

Party Affiliation *

Republican Party

Democratic Party

Independent Party

Other Party or Non-Affiliated

I am not registered to vote

Submit

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