Issues Survey - 72nd Assembly District
Please complete the following survey to let me know where you stand on important issues facing our district.
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Full Name (First & Last) *
Home address *
Email address (optional)
Which voting municipality do you reside in? *
I primarily identify as *
Please check your top 4 issues of concern. *
Required
Clean Water (choose all that apply)
Gun ownership (choose all that apply) *
Required
Livable Wage (choose all that apply) *
Required
Reproductive Rights (choose all that apply) *
Required
Education Funding (choose all that apply) *
Required
Marijuana Legalization (choose all that apply) *
Required
Statewide broadband (choose all that apply) *
Required
Affordable Healthcare (choose all that apply) *
Required
Mental Health Services (choose all that apply) *
Required
If interested in volunteering your time and talents with the campaign, please share your contact information, phone number and/or email. (Optional)
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