Team Ava Volunteer Registration
PAID FOR BY DR. AVANESE TAYLOR FOR BREVARD SCHOOL BOARD DISTRICT 4. This campaign is NOT sponsored or endorsed by the Department of Defense (DOD) or the United States Navy.
Volunteer Name:
First Name
Last Name
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Polling District:
Contact Phone:
Please enter a valid phone number.
Contact Email:
example@example.com
Party Affiliation:
Registered to Vote?
Yes
No
Planning to Vote?
Yes
No
Voting Intention:
Supporter
Leaning toward candidate
Undecided
Leaning toward opponent
Supporting opponent
Prefer not to answer
Not at home
Needs:
Petition
Absentee ballot
Ride to polls
Yard Sign
Will support the campaign by:
Volunteering
Canvassing
Working to get out the vote
Making donation
Other
Additional Information/Issues:
Submit
Should be Empty: