Debt Collective Canvassing Intake
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Name
Your answer
Phone
Your answer
Email
Your answer
Have you ever taken out a loan for a basic need?
Required
Add more detail here if it was provided:
Your answer
Have you sometimes struggled to keep up with payments on household debt?
Have you ever been harassed by a lender or debt collector?
Add more detail here if it was provided:
Your answer
Are there enough jobs for everyone who wants one in your community?
Do you and your neighbors have the opportunity to acquire a high quality and affordable education?
Do you feel like you and your neighbors have access to health care and other basic services?
Add more detail if it was provided:
Your answer
Are there any companies, politicians or others who are causing local problems?
Your answer
Are you interested in learning more about how to dispute your debts? Which kinds of debts?
Your answer
List any feedback the person gave on the policy points.
Your answer
Anything else the person said or asked about that you want to record?
Your answer
Is this person interested in joining a phone call or in person meeting
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