JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Engine Advocacy Survey
Tell us about you! Questions? Contact
graham@engine.is
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Company
*
Your answer
Address
*
Your answer
Zip Code
*
Your answer
What policy areas are you interested in?
Capital Access (tax, trade)
Intellectual Property (patents, copyright)
Intermediary Liability (user-generated content)
Data & Security (encryption, privacy)
Net Neutrality
Infrastructure (broadband, spectrum)
Talent (immigration, education)
Tech Diversity
Other:
Are you interested in being profiled for our #StartupsEverywhere initiative?
Yes
No
Maybe
Clear selection
Do you have any relationships with lawmakers you want us to know about? (representatives, senators, city council members, etc.)
Your answer
Anything else you want us to know?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Engine.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report