JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
VOTER PLEDGE: Participatory Budgeting in Long Beach
PARTICIPATORY BUDGETING VOTE: March 21-27, 2015
Will you come out and vote in March on how to spend $250,000 to improve District 9 in Long Beach?
Sign in to Google
to save your progress.
Learn more
* Indicates required question
I PLEDGE TO VOTE!
*
YES, I WILL VOTE
I WILL BRING A FRIEND TO VOTE
Other:
Required
NAME
*
Your answer
EMAIL
*
Your answer
ADDRESS
*
Street Address and Zip Code
Your answer
PHONE
*
Your answer
How do you want to be reminded about the vote?
*
Check all that apply
Phone call
Email
Mailing to my home
Other:
Required
Would you like to volunteer as a poll worker during vote week?
*
The PB vote is a community-led event, so we need your help to make it happen.
Yes, contact me!
No, thanks.
How did you hear about the Participatory Budgeting Vote?
*
Check all that apply
Word of mouth
Social Media (Facebook, Twitter)
www.pblongbeach.org
www.insidedistrict9.com
Other:
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report