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Canvassing Weekend (Friday, January 27th)
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Name
*
Your answer
PSU Email
*
Your answer
Phone Number
*
Your answer
Year
*
Freshman
Sophmore
Junior
Senior
Other:
Emergency Contact Name
*
Your answer
Emergency Contact Relation to You
*
Your answer
Emergency Contact Phone Number
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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
:
AM
PM
Are you allergic to anything?
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Your answer
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