LWV of Fairfax Screening of "GerryRIGGED" Questions for the Redistricting / GerryRIGGED Panelists * 1. Are you a Virginia resident? Yes No * 2. What question would you like to be addressed at the GerryRigged Film and Forum? * 3. If you have an additional question about gerrymandering, please write it here. * 4. Do you support redistricting reform in Virginia? Yes. If, yes, go to question 5. No. If no, go to question 6. I am undecided and would like to learn more. Other (please specify) * 5. Explain why you support Redistricting Reform. * 6. Explain your opposition to Redistricting Reform. * 7. May we publish your question or comments after the event? Yes No * 8. How did you hear about this event? * 9. What is your current occupation? * 10. Your contact information (optional, but it helps us know which legislative district you are in) Name Organization / School / an interested citizen City/Town (very helpful!) State/Province ZIP/Postal Code Email Address Phone Number Done. Thank you for helping make democracy work!