LULAC Council Survey for “The Future is in Your Hands: Vote”
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1
. What is your first name?
What is your first name?
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2
. What is your last name?
What is your last name?
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3
. Phone
Phone
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4
. E-mail
E-mail
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5
. What is your mailing address?
What is your mailing address?
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6
. What is your community organization or LULAC Council number (and name):
What is your community organization or LULAC Council number (and name):
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7
. What is your title or position in your LULAC Council?
What is your title or position in your LULAC Council?
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8
. Are you currently registering voters?
Are you currently registering voters?
Yes
No
Are you part of any other organizational affiliations/partnerships where you registered voters?
9
. If so, how many have you registered to date?
If so, how many have you registered to date?
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10
. If you have a voter registration goal, how many voters do you want to register by Election Day?
If you have a voter registration goal, how many voters do you want to register by Election Day?
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11
. List the counties you plan to conduct voter registration/voter education/voter protection or get out the vote.
List the counties you plan to conduct voter registration/voter education/voter protection or get out the vote.
County 1:
County 2:
County 3:
County 4:
County 5:
County 6:
County 7:
County 8:
County 8:
Any others:
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12
. Which of the items below are you interested in receiving from LULAC National (check all that apply):
Which of the items below are you interested in receiving from LULAC National (check all that apply):
Training on how to run voter registration campaign in your state
Voter Registration Supplies (clipboard & pens)
Marketing Materials (Banners, T-Shirts, Decals, Buttons)
Other (please specify)
13
. Optional:
What Advocacy Issues are most important to your community? (Please check all that apply)
Optional: What Advocacy Issues are most important to your community? (Please check all that apply)
Women’s Rights
Technology
Social Security
Social Security
Seniors
Immigration
Housing
Hispanic Representation
Health
Environment
Education
Citizenship and voting
Other (please specify)
14
. Are there any upcoming community festivals/ events where you can conduct voter registration? (Please list date and event name)
Are there any upcoming community festivals/ events where you can conduct voter registration? (Please list date and event name)
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