Request edit access
Medical Choice Canvassing Campaign
We are going door to door in select senate districts to leave literature and to try and speak with voters about Choice and the bills to remove the Religious Exemption.   We need walkers/knockers and drivers.
Sign in to Google to save your progress. Learn more
What is your name *
What is your cell phone number? *
What is your email address?  (We will share your contact info with other volunteers to connect you.) *
To which of the following towns (and their surrounding areas) are you willing to travel? (These are listed by district, so some towns overlap.) *
Required
If you are not able to help in the towns listed above, please let us know what town or senate district you live in.  We will contact you if we need help closer to your area:
What days of the week work best for you?
Are you willing to be a team leader if we need more (to help coordinate outings and disseminate literature to canvassing teams)?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms