Private GCVC Website - Request to Join
Georgia Coalition for Vaccine Choice
Name ( First, Last) *
Your answer
E-mail *
Your answer
Are you already a member of the closed Facebook group, Georgia Coalition for Vaccine Choice? *
If you are on Facebook, what is your user name? *
The following information is required to become a GCVC Member. While GCVC membership is required to access the private Facebook group and website, it does not guarantee immediate access to the private Facebook group or website. A membership volunteer will review your request. If you choose not to become a member at this time, we ask you to please like our public Facebook page at https://www.facebook.com/VCHFGA/
I am a registered Georgia voter. *
To find your State Representative AND Senator districts, go to: https://openstates.org . Please list your STATE HOUSE REPRESENTATIVE (lower assembly) in the space provided. *
Your answer
To find your State Representative AND Senator districts, go to: https://openstates.org . Please list your STATE SENATOR (upper assembly) in the space provided. *
Your answer
To find your US Representative district, go to: http://www.house.gov/representatives/find/ . Please list your representative below. *
Your answer
Are you in favor of vaccine choice? *
What does vaccine choice mean to you? *
Why are you interested in joining GCVC ? *
Your answer
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