Student Voter Registration Project: Survey and Order Form

Annual Survey and Order Form

You may submit your school's survey response and order voter registration cards electronically using the following form:

School System *

High School

California Community College

California State University

University of California

Private College

School Name *

Voter Registration Contact Name *

Address *

City *

Zip Code *

Phone Number *

Email Address *

Confirm Email Address *

Is the link to the Secretary of State's online voter registration application posted on the school's website?

Select one *

Yes

If you responded "Yes" to the previous question, please enter the school's website address

Website Address

Would you like to request paper voter registration cards?

Select one *

Yes

Please enter the number of voter registration cards you would like us to send you in each language.

English

Spanish

Chinese

Hindi

Japanese

Khmer

Korean

Tagalog

Thai

Vietnamese