XL Dissent West Coast
Please fill out all applicable questions if you will be attending the XL Dissent West Coast Action in San Francisco on March 3rd
What is your first and last name?
What is your email address?
Where are you coming from?
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?
Will you need housing in the Bay Area?
(If you can find your own housing, please do so, as our resources are limited)
Yes - Please find me a place to stay
No - I don't need housing
If so, when will you be arriving in the Bay Area?
Saturday March 1st
Sunday March 2nd
Will you be participating in civil disobedience during the action?
(Are you willing to risk arrest?)
Not sure yet
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
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service