Representation Matters Sign Up
Thank you for getting involved in the legislative redistricting process in Springfield, West Springfield, Chicopee and Holyoke!  We look forward to seeing you at an upcoming community forum on July 14th or July 28th.  Please call us at 413-214-5100 with any questions.  Gracias por participar en el proceso de redistribucion de distritos legislativos en Springfield, West Springfield, Chicopee y Holyoke.  Esperamos verte en el proximo foro.  Por favor llamenos con cualquier pregunta.  
Sign in to Google to save your progress. Learn more
Name/Nombre *
Organization/Business Name (if applicable)/Organizacion/Negocio (si es aplicable)
Phone # /Telefono *
Email/ Correo Electrónico *
Would you like to receive texts from PVP about this? Le gustaria recibir mensajes de texto de PVP sobre esto? *
Are you a member of PVP? Eres miembro de PVP? *
Would you like more information about PVP membership? Le gustaria obtener mas informacion sobre la membresia de PVP?
Clear selection
My community of interest is... (please check all that apply) Mi comunidad de interes es... Agregar toda las que aplican *
Required
How would you like to participate in an upcoming Representation Matters Community Forum? (Please check all that apply) Como le gustaria participar en el proximo foro de la comunidad? *
Required
Which virtual forum do you plan to attend? A que foro asistiras?
Clear selection
Are you committed to working with people from different backgrounds and remaining open to different viewpoints and lived experiences? Esta comprometido a trabajar con personas de diferentes origenes y a permanecer abierto a diferentes puntos de vista y experiencias?
Clear selection
What other questions do you have? Que otras preguntas tiene?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pioneer Valley Project. Report Abuse