Are you ready to help?

When You Vote – I Win.

Activist Enagement form

Check the boxes when the answer is yes.

Do you plan to vote in the next election?

Do you need help getting registered to vote?

Do you need help getting an absetee ballot?

Do you need help finding out candidates policy postions?

Do you need help finding out where your polling location is?

Will you get pledges from others to vote?

Do you want help? Please fill out the contact info.

If you are willing to get voting pledges from others, how many people will you approach?

What county do you live in? (example – Wayne)

What city do you live in within that county? (example – Detroit)

If you are willing to have us contact you please fill out the boxes below.

Name(Required)

First Last

Phone

Enter Email Confirm Email