JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
District 84 August Constituent Survey
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Is it appropriate to close tax loopholes, make our tax system more transparent, and restructure the way we collect taxes to provide a $2.7 Billion tax reduction?
Choose
Yes
No
Unsure
Will the Lake Facilities Authority provide a path for full restoration at Grand Lake St. Marys?
Choose
Yes
No
Unsure
Should government reduce involvement in the healthcare industry?
Choose
Yes
No
Unsure
Will agriculture in the urban classrooms improve student performance and reduce dropout rates?
Choose
Yes
No
Unsure
Please share any other thoughts you may have regarding issues in the news this month:
Any feedback you can provide will be helpful
Your answer
First Name
*
Your answer
Middle Name/Initial
Your answer
Last Name
*
Your answer
Suffix
Your answer
Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
County
*
Choose
Auglaize
Darke
Mercer
Shelby
Other
Email Address
*
Your answer
Phone Number
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
