Nebraskans for Medical Marijuana Volunteer Intake Form

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All information shared is confidential and will only be viewed by volunteer coordinators. If you have any further questions or comments, please contact info@nebraskamarijuana.org

Are you a Nebraska resident? *

Yes

Are you at least 18 years old or older? *

Yes

No, but I will be soon and want to help!

Name *

Phone number

Street address

City or town

Zip code

What county do you live in? *

Have you been trained to circulate petitions? *

No, I need to be trained.

Yes, I've already been trained.

Yes, but I would like to review the training.

Do you have all necessary materials? *

Yes, I have my training materials and petitions

No, I have never received training materials and petitions.

I have training materials, but need more petitions.

Are there any other ways you can help the campaign, such as being a public speaker or writing a letter to the editor for your local paper?

Submit

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