Clone of 2025 Civic Engagement Reflection Card

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number

Please enter a valid phone number.

4

If you are a current student, what school do you attend?* This field is required.If you are an alum, what school did you attend? Put n/a if this does not apply

5

What is your graduation year?If you are an alum, what year did you graduate?

6

What organizations are you a part of?For example, campus-based organizations or community organizations

7

What’s one issue or problem you/your people are facing right now?* This field is required.

8

How does that problem show up in your life? * This field is required.

9

Who do you think has the power to make change on that issue? * This field is required.

10

What would political participation look like if it didn’t revolve around voting?* This field is required.

12

In 5 words or less, what keeps you going?* This field is required.

13

Do you want to get plugged in to our upcoming legislative session advocacy?

YESNO