Registration Form for Reclaiming Florida's Future
Please Note: Online registration closes Mon. 3/4/19 at 11:59pm (But if you can still access this, go ahead and sign up)

We're looking forward to meeting you on 3/13/19, and joining forces in the fight to RECLAIM FLORIDA'S FUTURE FOR ALL! This short survey will let us know more about you, and where you will be able to contribute the most during "Reclaiming Florida's Future for All." Your input is important to us, and it is our hope that you will enjoy participating!
Sign in to Google to save your progress. Learn more
First Name: *
Last Name: *
Phone Number: *
Email address: *
Physical address *
We will not share your address with any third party. The purpose of this question is to verify your Florida Legislative representatives.
Zip *
City *
County *
Who is your representative at the State House? *
Who is your State Senator? *
Hint: Not Marco Rubio or Bill Nelson. If you're unsure, you may check at: https://www.flsenate.gov/senators/find
How will you be traveling to Tallahassee? *
We will be providing transportation from major population centers. Stay tuned for details and indicate your preference below
Where will you be staying March 12th? *
For a bed/ mattress at the Center, please include your payment at the end of this survey
Lunch will be provided on 3/13 for those who complete this form. Do you have special dietary needs? *
Required
What times will you be attending on March 13th? *
The event itself goes from 10am-4pm
Will you contribute $20 to offset transportation and food costs? *
We want to make this accessible to everyone, but if you are able to offset transportation and food costs, please indicate below. If another amount, please indicate that in 'Other'
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms