Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Get Involved! - Gayatri Agnew for Bentonville City Council 2024
Thanks for being a supporter of Gayatri Agnew for Bentonville City Council 2024! Get involved to reelect Gayatri this November by filling out this form, and someone from the campaign will follow up shortly. Feel free to email us with any questions at
agnewforcitycouncil@gmail.com
By providing your phone number below you agree to receive occasional updates from People for Gayatri Agnew. Reply STOP to opt-out.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
ZIP Code
Your answer
I endorse Gayatri Agnew for Bentonville City Council!
Yes!
Clear selection
Position/Title for Endorsement
Your answer
How Can You Help?
Door knocking
Calling voters
Writing postcards to voters
Putting up a yard sign
Hosting an house party or fundraiser
Other:
Any questions/comments?
Your answer
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
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
