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* 1. Name: First, Middle Initial, Last

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* 2. Email:

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* 3. Phone Number:

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* 4. Physical Address:

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* 5. Mailing address if different than Physical Address:

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* 6. Nez Perce Tribe enrollment number (If applicable):

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* 7. Did you or a member of your household complete the 2020 Census?

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* 8. Did you or a member of your household register to vote for the November 3, 2020 General Election?

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* 9. Did you or a member of your household request an application for an absentee ballot for the November 3, 2020 General Election?

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