JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Luzerne County Community College Students for Shapiro
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Year
Fist year
Second year
Third year
Other
Clear selection
Do you have any experience in any of the following?
Canvassing
Social Media
Phone Banking
Other
Would you like to be added to the Slack channel?
Yes
No
I’m not sure what that is
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
