JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Volunteer Sign Up
Sign up below to help the Committee to Elect Adam Gomez with electing Adam as the next Senator for Chicopee, Springfield, and West Springfield.
Your support today will bring us closer to victory on September 1st!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Street Address
*
Your answer
City/Town
Your answer
Zip Code
Your answer
What's the best way to reach you?
*
Phone call
Text
Email
Required
What languages do you speak?
Arabic
Cantonese
Cambodian
English
French
Greek
Mandarin
Polish
Portuguese
Russian
Spanish
Italian
Vietnamese
Other:
How can you help?
*
Door knocking
Phone banking
Data Entry
Social Media Ambassador (Share & promote content)
Donate:
https://secure.actblue.com/donate/gomezforsenator
Host a House Party Fundraiser
Display a lawn sign
Other:
Required
What is your Weekday availability?
7 - 9 AM
9 - 11 AM
11AM - 1PM
1 - 3 PM
3 - 5 PM
5 - 7 PM
7 - 9 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
7 - 9 AM
9 - 11 AM
11AM - 1PM
1 - 3 PM
3 - 5 PM
5 - 7 PM
7 - 9 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Do you own a business where we can display a campaign sign? If yes, please list name & address:
Your answer
Comments
Your answer
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
