Request our services - Chippewa Valley Votes
Would you like to have voter registration and assistance at your event, business, or facility? Would you like someone to come speak to your club or group about voting?
We can send a fully staffed voter registration booth to your location. Our knowledgeable and non-partisan volunteers are ready to work with you. We have tables, literature, tablets, clipboards, laptops, and a printer. Use this form to provide us information about how you would like to work with us.
For more information about Chippewa Valley Votes, visit our website at:
http://www.chippewavalleyvotes.org
What type of service are you requesting?
Voter registration
Education (presentation about voting)
Training (how you can register voters)
Other:
Clear selection
What is your organization's name?
Your answer
What is the mission of your organization?
Your answer
What type of organization?
Business
Non-profit organization
Community group
Government agency
University
Club
Social service provider
Other:
What is your organization's website?
Your answer
Where is your location?
Your answer
What is the street address of your location?
Your answer
Is the location indoor or outdoor?
Indoor
Outdoor
Clear selection
Does your location have a wifi connection?
Yes
No
Maybe
Clear selection
Is this a recurring or one-time request?
One-time
Weekly
Monthly
Annual
I'm not sure yet
Other:
Clear selection
Can you provide tables? If yes, how many?
No, we cannot provide tables.
Yes, we can provide one table.
Yes, we can provide more than one table.
Clear selection
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
