JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Tennessee Organizing for Power Statewide - COVID-19 Demands SIGN ON. JOIN US.
View the demands here:
bit.ly/TNOrg4PowerCOVID
*SHARE FAR & WIDE*
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Are you signing on to the proposal as:
An organization
An individual
Both
Other:
Clear selection
First name
Your answer
Last name
Your answer
Email address
*
Your answer
Phone
Your answer
Do you have regular access to the internet?
Yes
No
Limited access
Other:
Clear selection
Zip code
Your answer
City
Your answer
State
Your answer
County
Your answer
Organization (if you're signing on as an organization)
Your answer
Organization description (if you're signing on as an organization)
Your answer
Do you have authorization to sign for the organization? (if you're signing on as an organization)
Yes
No
Maybe
Other:
Clear selection
If you are signing on as an organization, is your organization:
local
regional (members in more than 1 counties/parishes WITHIN 1 STATE)
statewide
national
regional (members in SEVERAL STATES)
Other:
Clear selection
Do you want to get more involved in Tennessee Organizing for Power Statewide?
Yes
No
Other:
Which of the issues do you care most about?
Local Jails, Detention Centers, and Tennessee Department of Corrections
Prison Release
Housing
Worker's Rights
Economic Justice
Health Care
Voting Rights
Education and Children
Agriculture and Natural Resources
Other:
Is there anything else you want to say?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Free Hearts.
Report Abuse
Forms
