JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Avenues to Civic Action Application
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Please enter your name
*
Your answer
What are your pronouns?
*
She/her/hers
He/Him/His
They/Them/Theirs
Other:
What race/ethnicity are you?
*
Your answer
What is the best phone number to reach you at?
*
Your answer
What is your mailing address?
*
Your answer
What school do you go to?
*
Your answer
What grade are you in?
*
Freshman
Sophomore
Junior
Senior
In college
How old are you?
*
Your answer
What time are you able to meet on Saturdays? Please choose all that you are available for.
Mornings (anywhere from 9 am - 11 am)
Afternoons (anywhere from 1 pm - 4 pm
Evenings (anywhere from 5 pm - 8 pm)
Where did you learn about Avenues to Civic Action? If a teacher told you about us, please write down their name.
*
Your answer
What are some issues/topics you are interested in or passionate about and why?
*
Your answer
Do you feel young people are doing enough to get involved with the politics of today? Please explain why.
*
Your answer
What are you hoping to learn and get out of this program?
*
Your answer
Are you registered to vote?
*
Yes
No
I am pre-registered
I am not eligible to vote
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of UC Davis.
Report Abuse
Forms
