What is your first and last name?

This is a required question

What is your email address?

This is a required question

Where are you coming from?

This is a required question

If you're traveling to the Bay Area, are you coming with a group?

If so, how many people are in your group, and what are their names?

This is a required question

Will you need housing in the Bay Area?

(If you can find your own housing, please do so, as our resources are limited)

This is a required question

If so, when will you be arriving in the Bay Area?

This is a required question

Will you be participating in civil disobedience during the action?

(Are you willing to risk arrest?)

This is a required question

Will you be attending the action brief in the afternoon of March 2nd at UC Berkeley?

This is required if you are going to risk arrest

This is a required question

XL Dissent West Coast