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Vot-ER Custom Materials

Thank you for your interest in ordering Vot-ER materials for your institution or team! Upon filling out this form, you'll receive a custom, digital suite of resources designed to help you integrate voter registration into your daily practice. These digital resources are free of charge.

Step 1 of 3: Basic Information

First Name

Last Name

Email Address

Phone Number

Your Occupation

Organization Name

What group, team, department, etc. are you ordering for?

What state is your organization in?

The majority of my patients are (select all that apply):

The majority of my patients are (select all that apply):

My institution views itself as a space that is designed to serve (select all that apply):

My institution views itself as a space that is designed to serve (select all that apply):

Which of the following best describes you?

Which of the following best describes you?
A
B
C
D
E