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*** 12th Congressional District Democrats Survey ***

* What is your last name?
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* What is your first name?
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* What city in our district do you live in?
* Email address?
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* Email address?
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* Cell Phone Number
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* Would you be interested in taking on a more active role in the 12th Congressional District Democrats?
* If you selected yes, what committees are you interested in joining?
* Are you a Precinct Delegate?
* How many meetings have you attended in the last two years?
* What would improve our voter engagement efforts in the 12th District?
* What issues do you believe are the most important to voters in the 12th District? (Select all that apply)
* What additional events would you like to see hosted by the 12th Congressional District Democrats?
Is there any other information you want to share with leadership of the 12th District?
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