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* 1. What is your name?

* 2. What is your e-mail address?

* 3. What is your phone number?

* 4. Are you affiliated with a particular organization? If so which organization?

* 5. When are you available to attend the People's Settlement?

* 6. Are you available to canvas or phone bank and can we contact you with more information?

* 7. Are you interested in facilitating a Teach-In (Popular Education) Event during the People's Settlement?

The Teach-In could be anywhere from 30 minutes-1 hour on a weeknight or 1-3 hours on a weekend. Teach-Ins could be about your organization and what it is working on currently or other Activist skills, etc.

* 8. Are you interested in providing entertainment (music, art, circus skills, sing-a-longs, plays, etc) during the People's Settlement?

* 9. Can you provide supplies for the Encampment? If so what can you bring and when? (Meals, Snacks, Tents, Water, Blankets, Sign Making Supplies, etc)

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