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Activate a Vot-ER Badge
Badge Number
*
Required
Your
badge number
is a numeric code after the
vote.health
link
on the front of your badge
:
First Name
*
Required
Last Name
*
Required
Email
*
Required
Organization
*
Required
(Please use the full name of your organization; choose "Other" if not listed)
State
*
Required
Occupation
*
Required
Phone Number
Submit