Corinth-Shiloh Petition Interest Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in helping the Corinth-Shiloh Fire Department. "Signatures for Support" is a campaign to raise awareness and signatures of support for a vote on the future of the department. Please note your signature is not a vote "yes" or a vote "no," simply a statement that you support the departments desire to move forward with the special purpose tax district. Please note the steps required to complete the petition process:

Step 1: Fill out this quick form and submit.

Step 2: Once your form is received, a member of Corinth-Shiloh will assist you in filling in your voter ID number and send you an automated email with a .pdf attachment. (Please allow 48 hours for processing)

Step 3: You will receive an email with a .pdf attached. Please print off the attached petition and SIGN TO SUPPORT!

Step 4: Please mail your petition to 940 Old Clemson Hwy, Seneca, SC 29672 with appropriate postage, or drop off at Corinth-Shiloh Fire Department

Step 5: Share this form with your friends so they too can support Corinth-Shiloh Fire Department!

Is your address within Corinth-Shiloh Fire District?

Yes

Maybe

Clear selection

Are you a registered voter? *

Yes

Maybe

What is your legal First Name? *

What is your legal Last Name? *

What is your legal Middle Name? *

Please indicate NONE if there is none.

What is your Street Address? *

What is your City, State and Zip?

Seneca, SC 29672

Seneca, SC 29678

Clear selection

Precinct of Voter *

Shiloh

Ravenel

Newry / Corinth

Seneca 2

New Hope

Not sure

Phone number *

Email *

Statement of Understanding *

I understand that this form is collecting data to fill in a petition for the Corinth-Shiloh Fire Department. I also understand the petition is NOT valid until it is signed and returned by the person indicated above. I understand that electronic signatures are NOT admissible. Please sign with black ink and return in the steps outlined above to assist the department in the "Signatures for Support" campaign.

Email list *

I would like to be included in emails of future events, programs and campaigns.

Please do not include me in the email list for information on events, programs and campaigns.

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Corinth-Shiloh Volunteer Fire Department.

Does this form look suspicious? Report

Forms