Canvassing Weekend (Friday, January 27th)
Name
Your answer
PSU Email
Your answer
Phone Number
Your answer
Year
Emergency Contact Name
Your answer
Emergency Contact Relation to You
Your answer
Emergency Contact Phone Number
Your answer
Emergency Contact Email
Your answer
Can You Drive?
If so, how many including yourself?
Your answer
What time can you leave on Friday?
Time
:
Are you allergic to anything?
Your answer
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