NSML Volunteer Intake Form
All information shared is confidential and will only be viewed by volunteer coordinators of Nebraskans for Sensible Marijuana Laws. If you have any further questions or comments, please contact
Are you a Nebraska resident?
Are you at least 18 years old or older?
No, but I will be soon and want to help!
Are you registered to vote?
No, but I want to get registered
Yes, but I need to update my registration
Address (please put FULL mailing address)
What county do you live in?
Are you willing for your contact information to be shared with those in your county so that we may better coordinate petition efforts?
Yes, I'm willing to share my contact information with those in my county.
No, I would like my contact information to remain private.
Have you been trained to circulate petitions?
No, I need to be trained.
Yes, I've already been trained.
Yes, but I would like to review the training.
Do you have all necessary materials?
Yes, I have my training materials and petitions
No, I have never received training materials and petitions.
No, I have training materials but am in need of more petitions.
Are you willing and able to go to events in your county to gather signatures?
Are you willing and able to go door-to-door in your community to gather signatures?
Do you have access to a form of transportation?
Yes, I have access to a car and can drive.
Yes, I have access to a car, can drive, and am willing to drive others in my area.
Yes, I have someone who can drive me places.
Yes, I take public transportation.
Yes, I use my bike for primary transportation.
No, I would like my contact information shared with local volunteers who can drive me.
No, I do not and would not like my contact information shared with other volunteers.
No, but my community is small enough that I can walk to where I need to go.
Are you proficient in more than one language? (i.e. Spanish, Arabic, ASL)
Do you want to help but have a disability that would make it difficult or prevent you from doing so? If so, please explain below what we can do to accommodate you.
Any additional comments or information that you would like us to know?
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