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Young EcoSocialists AZ Sign-Up Form
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First Name
Your answer
Last Name
Your answer
Phone Number
Your answer
Email
Your answer
Address
Your answer
How did you hear about Young EcoSocialists AZ?
E-mail Invitation
From a friend, family member, coworker, etc.
Online/Social Media
Other Media (flyers, mailers, etc.)
Other:
Clear selection
Are you between the ages of 14 and 35?
Yes
No
Clear selection
Are you a registered voter in Arizona, and if so, with what political party?
Green
Republican
Democrat
Libertarian
Registered, but unaffiliated/independent
Not Registered
Clear selection
On a scale of 1 to 5, with 1 being not knowledgeable at all and 5 being very knowledgeable, how much do you know about EcoSocialism and the Global Green Movement?
Not knowledgeable at all
1
2
3
4
5
Very knowledgeable
Clear selection
From what you know of EcoSocialism and the Global Green Movement, how would you rate your favorability towards those ideas?
Very Unfavorable
1
2
3
4
5
Very Favorable
Clear selection
What are some of the local issues affecting you and your community that you are passionate about? How would you like to see the Young EcoSocialists help?
Your answer
Which working committees would you be interested in joining ?
Finance Committee
Media Committee
Education Committee
Action Committee
Not Sure
Any other special skills or experience that you can bring to the organization?
Your answer
What times and days of the week are you most available?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning 8AM -11AM
Mid-Day 11AM - 2PM
Afternoon 3PM - 6PM
Evening 6PM - 9PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning 8AM -11AM
Mid-Day 11AM - 2PM
Afternoon 3PM - 6PM
Evening 6PM - 9PM
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