Registration Form: Wisconsinites Uniting for a Safe Election Season on July 27, 2024
Welcome to the registration for Wisconsinites Uniting for a Safe Election Season, a free community event organized by Common Agency, Urban Rural Action, and WisACT. 

Find YOUR opportunity to strengthen your community during the upcoming election season! Join us on Saturday, July 27 at 12:30-5 pm in Kenosha, WI to promote safety and resilience in Southeast Wisconsin before, during, and after the elections.

The event will feature free food, music, a keynote panel, opportunities to support local community initiatives, and interactive workshops to build your skills in constructive dialogue, de-escalation, media outreach, and community safety.

Please complete this form by July 4, 2024 to confirm your participation in the public event at the Civil War Museum in Kenosha, WI on July 27 from 12:30 pm - 5 pm. Once you have registered, you'll receive a calendar invitation.

Thank you!

Kamika Patel, UR Action Program Support
kamika@uraction.org
Sign in to Google to save your progress. Learn more
First and Last name
*
Email address
*
Phone number
*
Where do you live? (municipality, county)
*
Which of the following breakout sessions are you most interested in? *
In general, do your political views lean more to the left or the right? Please select the option that most closely describes your views, even if not a perfect fit.(Note: this information will be used ONLY to contribute to a politically diverse group of attendees and inform outreach efforts.) (Optional)
Clear selection
What is your age group? (Optional)
Clear selection
How would you describe your identity (race, ethnicity, religion, etc.)? (Note: this information will be used ONLY to ensure a variety of backgrounds and inform outreach efforts.) (Optional)
Why are you interested in participating in this event? (Optional)
Do you have any accommodations needs for this event?
Is there anything else you would like to add?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Urban Rural Action. Report Abuse