JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Yard Signs for Karen Zaccor for District 4!
We have yard signs and they look great! Please fill out this form if you would like one. We'll contact you to arrange drop off/pick up.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Street Address
*
Your answer
I would like a yard sign
Yes, I will pick it up from a location in Uptown
Yes, I would like it delivered to my house
Clear selection
I would like to pass literature at Early Voting Sites and/or on Election Day (11/5) (please check all that apply)
Early Voting (10/21-11/4)
Election Day (11/5)
Anything else you'd like to share with us?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy
Help and feedback
Contact form owner
Help Forms improve
Report