MAAC's "Drop the Mic" Voter Campaign Survey

Thank you for your interest in making your vote count with MAAC's "Drop the Mic" campaign. Please fill out the form below to either learn the importance of registering to vote and/or verify you've registered to vote. The deadline to register is October 11th! There's no time to waste! Filling out the form would also enter you into a drawing for a prize!!

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* 1. What is your first and last name?

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* 2. What is your email address?

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* 3. What is your ethnicity? (Optional)

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 4. What is your phone number? (Optional: if you may need transportation to vote, please list)

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* 5. Are you registered to vote? (If yes, skip question 6.)

Yes

Not sure

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* 6. Are you interested in becoming registered to vote?

Yes

I’d like more information first

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* 7. Would you like to learn more information on how to be fully informed at the polls?

Yes

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* 8. Will you need transportation to vote? (If yes, ensure phone number is listed)

Yes