Sen. Ron Wyden Town Hall Participation Form

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Live video participation in this virtual town hall on June 19th is limited to residents of Coos, Curry, and Douglas counties in Oregon.

All are welcome to view the town hall and all Oregonians are welcome to submit live questions via Facebook comments.

Contact info@townhallproject.com for more information.

Name *

Email *

Phone number *

County *

City *

Zip code *

Current occupation / phase of life (e.g. "transit worker," "student," "retired," "unemployed," "caring for elderly family member")

Issue you'd like to ask about. (We are *not* screening questions apart from those not appropriate or relevant, and to avoid multiple questions on the same topic) *

Have you used Zoom before?

Yes

Clear selection

Are you available between 10:30 am and Noon Pacific on Friday, June 19th? *

Yes

Maybe

Can you agree to the following statement: "I am a resident of the county indicated above. If invited to participate in the virtual town hall I will engage in a respectful and appropriate dialogue." *

Yes

Submit

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