Ballot PA Media Interest Form
In a critical election year, reporters have already begun reaching out to the Ballot PA campaign hoping to speak with/interview Independent voters in Pennsylvania. They are interested in why so many voters consider themselves Independents (43 percent of all voters according to a recent Gallup poll), and what independents' perspectives are when it comes to current high-profile races.

Would you be interested in speaking with a reporter? We're looking to build a shortlist of individuals across Pennsylvania who would be willing to speak with members of the press if called upon to do so. Whether you're registered Independent/unaffiliated, or simply consider yourself Independent (since our closed primary system forces so many voters to register with a major party just to have a say in the primaries), we want to hear from you!
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Phone (optional)
Choose which best describes you: *
The Pennsylvania COUNTY where you vote *
Your address (optional)
Your age (optional)
Your gender (optional)
Your race and ethnicity (optional)
Any other info / comments you'd like to share?
Permission to contact: *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Denny Civic Solutions. Report Abuse