Request edit access
Volunteers for Team Denyse
Thank you for signing up to collect signatures on petitions to re-elect Rep. Denyse Wang Stoneback as State Representative of the 16th District! Please complete the questions below.

Sign in to Google to save your progress. Learn more
Email *
First Name: *
Last Name: *
Street Address: *
Town, State *
Zip code *
Mobile: *
How many petition sheets do you need? (There are spaces for 20 signatures on each sheet.) *
I attest that I am fully vaccinated from COVID-19 and that I will abide by CDC guidance (e.g., mask wearing, etc.) while canvassing. *
Do you require any special accommodations due to a disability?   *
I would like to support Rep. Denyse Wang Stoneback's re-election campaign by:  
Clear selection
Please include any other notes, comments, or questions you may have.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Denyse Stoneback. Report Abuse