SiX Democracy Champion Survey
If you're a state legislator interested in becoming a SiX Democracy Champion, fill out this quick survey! If you're already a Democracy Champion, use this survey to provide us with more information on your background and needs.

The Democracy Project is a new national initiative from SiX that empowers and emboldens state legislators to be dynamic advocates for a powerful, inclusive and participatory democracy. The project unites state legislators behind a bold vision and values platform and deepens legislative impact in state capitols across America.

Join us!

(Email democracy@stateinnovation.org or visit stateinnovation.org/democracy for more information.)
Full Name *
Your answer
Elected Office Title *
(E.g. Delegate, Representative, Senator)
Your answer
State *
I would like to join SiX's Democracy Project and I endorse the Vision and Values Platform. *
Preferred Email (for SiX's Democracy Team to reach you) *
Feel free to list multiple emails if needed.
Your answer
Staff Contact Information
If you'd like your staff to receive SiX Democracy Project updates, list their names and emails here.
Your answer
Facebook Profile Link
If you use Facebook, we'll follow you and invite you to the private Democracy Champions Facebook group!
Your answer
Twitter Handle
Your answer
How long have you served in elected office for?
Gender Identity
Select all that apply
Racial / Ethnic Identity
Select all that apply
Additional Group Identities
Select all that apply
What democracy policy issues are you most interested in?
E.g. Campaign finance, census, civic education, election security, government ethics, redistricting, rights restoration, voter registration, or vote-from-home. Feel free to be as broad or specific as needed.
Your answer
What kind of resources, skill-building opportunities, and support would you most like to receive from SiX's Democracy Project?
Select all that apply
Anything else you'd like to share or ask?
If you need, please use this space to share additional context on your needs and interests in the democracy space. Or add any questions for the SiX Democracy Team.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of State Innovation Exchange (SiX). Report Abuse