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Unregistered Voter
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*
" indicates required fields
Please enter your best contact information.
Name
*
First
Last
Address
*
Street Address
City
ZIP / Postal Code
Vote Pledge
*
I Pledge to Vote!
*
Cell Phone
*
Email Address
*
Congregation / Organization
*
Type ‘Other’ if you do not see your organization.
Other ( please specify )
What is your voting plan?
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Early
On Election Day
By Mail
Will you join the team to increase voter turnout?
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Yes
No
Maybe
Comments
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