Pennsylvania 2023 Municipal Election Survey
Did Your Vote Count?
Name
*
First Name
Last Name
Address
*
House/Apartment Number
Street Name
City
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What County do you live in?
*
1. Did you vote in the November 7th, 2023 election?
Yes
No
2. To the best of your knowledge, how many people in your household were registered to vote on Nov. 7th 2023?
*
3. To the best of your knowledge, how many people voted on Nov. 7th, 2023 from your household?
*
5. If you voted on Nov. 7th, 2023, did you vote by mail or in person?
*
6. Have you voted in every election since you first registered to vote?
*
7. What year would you say you registered to vote?
8. Did you experience any issues when you voted on Nov. 7th, 2023? (If yes, please elaborate)
9. Would you be willing to sign an affidavit with this information you provided?
*
Yes
No
Maybe
10. Email Address
*
example@example.com
11. Phone Number
Please enter a valid phone number.
Submit
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