Citizen Portal Volunteer Form 
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Full Name  *
Email Address  *
Phone Number  *
Zip Code  *
I am willing to be a citizen volunteer for my: 
(check all that apply)
*
Required
What social channels do you use: (check all that apply) *
Required
Please note your social media usernames 
(ex: Twitter @paulballen, Facebook.com/PaulAllen) 
I am interested in: (check all that apply) *
Required
On a scale of 1-5, how do you feel about the Dignity Index? (Dignity Index Article *
Not Important
Extremely Important
Do you use Slack? 
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Additional Feedback: 
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