Ohio Poor People's Campaign Interest Survey
Please fill out this form to help us connect those who want to be a part of the Poor People's Campaign: A National Call for Moral Revival. You do not need to live in Ohio to fill this out. We will direct you to those organizing in your state.
* Required
Email address
*
Your email
If you do not currently receive emails from the Ohio Poor People's Campaign, there are a couple ways to do that. You can text the word MORAL to 90975 or go to poorpeoplescampaign.org and pledge to join the campaign. Pledging will automactically put you into the email system for the state. We have started Regional Google groups. Once you fill this survey out, you will be sent an invite to connect with members in your Ohio region. If you are not familiar with Google Groups, don't worry. We will help you through the process. Also, we will have Ohio regional meetings to help mobilize and support local communities and build power. It is the power of connecting local communities statewide that gives us our movement power. The more we are connected on the issues, the more we show solidarity and are united.
First Name
*
Your answer
Last Name
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
What County do you live in
*
Adams
Allen
Ashland
Ashtabula
Athens
Auglaize
Belmont
Brown
Butler
Carroll
Champaigne
Clark
Clermont
Clinton
Columbiana
Coshocton
Crawford
Cuyahoga
Darke
Defiance
Delaware
Erie
Fairfield
Fayette
Franklin
Fulton
Gallia
Geauga
Greene
Guernsey
Hamilton
Hancock
Hardin
Harrison
Henry
Highland
Hocking
Holmes
Huron
Jackson
Jefferson
Knox
Lake
Lawrence
Licking
Logan
Lorain
Lucas
Madison
Mahoning
Marion
Medina
Meigs
Mercer
Miami
Monroe
Montgomery
Morgan
Morrow
Muskingum
Noble
Ottawa
Paulding
Perry
Pickaway
Pike
Portage
Preble
Putnam
Richland
Ross
Sandusky
Scioto
Seneca
Shelby
Stark
Summit
Trumbull
Tuscarawas
Union
Van Wer
Vinton
Warren
Washington
Wayne
Williams
Wood
Wyandot
Other:
Phone Number -
*
Your answer
Phone Info
*
Landline
Cell
Ok to Text
Required
Do you receive emails from the Poor People's Campaign
*
Yes
No, please sign me up to receive emails
No
Not Sure, please sign me up to receive emails.
How did you find out about the Ohio Poor People's Campaign?
*
Social Media
An Organization that suppports the PPC
A Friend
Website
An Event
Are you affiliated with an organization, please list it here.
Your answer
Can you help us mobilize your community around the Poor People's Campaign?
*
Yes
No but I'd like to learn more about the campaign.
No but I can introduce the campaign to leaders of the community.
Maybe need more information
Everyone has something to offer to the Poor People's Campaign. WE ACCEPT ALL GIFTS! No matter what your situation, we can find a way for you to be involved. We value everyone's input. How would you like to be involved? You may check up to 3 boxes.
*
Movement Arts (MAT ( Visual art & Music, all other forms forms of cultural arts)
Outreach and Mobilizing
Communications - Traditional & Social Media/Overall - internal & External
Political Education - Organizing classes in the history of the movement and current organizing strategies.
Spiritual Council - Organizing Faith Groups & Clergy
Beloved Community Care Team - (Provide health & wellbeing support)
Organization & Union Moral Fusion Team - building a strong network aligned around the demands of the campaign
Other:
Required
What is the best way to contact you?
*
Email
Phone Call
Text
Need Communications to be mailed.
Other:
Required
Do you have any needs to help you participate fully in community with others? If yes, please let us know what those are.
Your answer
OHPPC T-Shirts!
Show you are part of the OHPPC Family. Order a OHPPC T-Shirt for yourself or Someone Else. Use this link to order a T-Shirt
bitly.com/ORDEROHPPCTSHIRT
Questions or Comments?
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms