JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Sign up to host a local event on December 13
Use this form so that we can post that this event is happening, and invite others to join you.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First name
*
Your answer
Last name
*
Your answer
Organization (optional)
Your answer
Email (will not be shared)
*
Your answer
MLA office or other location where you will meet (e.g. Grace Lore's constituency office)
*
Your answer
Address for meeting place
*
Your answer
What time will you start? (We are suggesting 5 PM for consistency, but other times are good, too)
*
Your answer
How many people do you think you'll bring along?
*
Your answer
What action are you imagining? (e.g. People sharing stories, a song, a speech)
*
Your answer
Can we share your name and organization on a website and social media? If you would like to list multiple hosts and organizations, please specify below as you would like us to present them.
*
Yes
No
Other:
If you are hosting the event at an MLA's office, can you confirm that you will reach out to invite the MLA?
*
Yes I will!
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Climate Emergency Unit.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
