Stop Funding Fracking Data Entry Form
Use this form to enter information from paper petitions collected in the field.
DOGWOOD - Stop Funding Fracking Data Entry Form
Use this form to enter information from paper petitions collected in the field
Event Information
Event type
door
street
event / table
other
Date of event/canvass
Name
First Name
Last Name
Address
Street address
format: 2B-123 Main St
City
name only
x
Postal Code / ZIP
6 CHARACTERS MAX, NO SPACES, CAPITALIZE
Province / State
Phone
Phone #
10 digits only ##########
Mobile #
if don't know, put in phone field
Email
Email 1
Email 2
Twitter handle
Engagement
Year of birth
Year of birth
Willing to volunteer
Willing to volunteer?
Yes
Hidden fields
Contact Information