Voting Rights Survey

The following questions ask for some personal information. Providing the following information is voluntary. Your information will not be shared or used for marketing of any kind. We collect this information for internal purposes and for reporting to our funding partners, at which time, your information will be de-identified.

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* 1. County

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* 2. Zip Code

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* 3. Polling Site

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* 4. Was the parking area accessible?

Yes

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* 5. Was the path to building accessible?

Yes

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* 6. Was the entrance accessible?

Yes

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* 7. Did you vote from your vehicle?

Yes. It was my choice.

Yes. I had to vote from my vehicle because my polling place was inaccessible.

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* 8. Did you need an accommodation that was not available? (Please explain.)

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* 9. Was the voting equipment accessible?

Yes

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* 10. Contact Information (Optional)

Name

City/Town

Email Address

Phone Number