JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Contact Us
Would you like to be a part of helping to make Canada a better democracy? We'd love to here from you!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Email
*
Your answer
Your Postal Code
*
Your answer
Phone number
Your answer
What questions do you have? Tell us about your interests, experience and skills that you can contribute to advocating electoral reform?
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
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