LWV of Fairfax Screening of "GerryRIGGED"

Questions for the Redistricting / GerryRIGGED Panelists

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* 1. Are you a Virginia resident?

Yes

No

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* 2. What question would you like to be addressed at the GerryRigged Film and Forum?

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* 3. If you have an additional question about gerrymandering, please write it here.

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* 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)

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* 5. Explain why you support Redistricting Reform.

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* 6. Explain your opposition to Redistricting Reform.

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* 7. May we publish your question or comments after the event?

Yes

No

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* 8. How did you hear about this event?

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* 9. What is your current occupation?

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* 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