2021 Ballot Request Form
Pacifica ByLaws Referendum 2021

Please note: If you are prompted to login to a google account please ignore this prompt. You do not need a google account to fill out this form. Information collected by this form is securely stored on Pacifica's server.

All ballots were sent out June 7th (e-ballots, paper ballots and postcards with unique voter id and pin). E-ballots come from vote@simplyvoting.com - please safe list this email and check your SPAM and all other folders in your email inbox before submitting a ballot request.

All ballots must be received by July 7th, 2021 11:59 PM EST. Please note paper ballots and postcards are sent first class from New York.

Please request an e-ballot if you have access to a computer. Paper ballot requests are open till June 22nd, 2021. E-ballots requests are open through July 6th at 11:59 PM EST. All valid member requests received prior to this deadline will be processed.

Many Pacifica operations run on Eastern time and our balloting vendor does as well. Ballots were emailed June 7, just after 12:01 AM ET. That means June 6, after 9 PM at the California stations and June 6, after 11 PM at the Houston station:

KPFA & KPFK members should search June 6, 2021 after 9:01 PM

KPFT members should search June 6, 2021 after 11:01 PM

WBAI & WPFW members should search June 7, 2021 after 12:01 AM

**Individual requests should only be submitted once as multiple requests slow down the processing time for everyone. Please do not submit this form twice.
**Please fill out 1 ballot per member.
**Do NOT put 2 people in one field.

Please fill out this form if:
1) You have not received a ballot.
2) You are a listener or staff member of KPFA, KPFK , KPFT, WBAI or WPFW eligible to vote in this referendum. Listener members are eligible if a donation of $25 was made or 3 hours of approved volunteer work completed between April 8 2020 and April 7 2021. Staff members are eligible if they are paid staff (on payroll as of April 7th 2021) or unpaid staff (30 hours of programming related work between January 7th and April 7 2021.

Email *
Alternate email
Please indicate the type of ballot request *
Station *
For staff only - indicate the program you work on and the supervisor of your work (if relevant). Please note that station management must approve your addition to the staff list eligible to vote.
Is this a second household ballot? *
First Name *
Last Name *
Street Address *
City *
State *
Zipcode *
Telephone Number *
Alternate address (for example a pobox)
Is there any other information you would like to send to the election staff? For example, this is a second household ballot. Remember 1 form = 1 individual ballot request. File 1 form per request.
A copy of your responses will be emailed to the address you provided.
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