JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Voting Commitment Form
*Please note that you may hear from a member of the Rodeph Shalom Voter Advocacy and Access Committee if you check this box.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Phone Number
Your answer
I commit to… (Please check all that apply below):
*
Voting in the November 3rd election.
Voting either by mail or at my polling location.
Helping register people to vote by participating in at least one phone banking session with One PA and RAC-PA.*
Helping at least three people I know to register or to vote. These are people who may have questions about how to vote or difficulty in reaching the polls on election day.*
Lobbying my county to implement best practices that enable voter access.*
Serving as a poll worker on election day.*
Other:
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Congregation Rodeph Shalom.
Report Abuse
Forms
