JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Volunteer for Commisioner Tick Segerblom
Join our campaign efforts to re-elect Commissioner Segerblom. Election Day is Nov 8 and early vote beings on Oct 22-Nov 4. For more information, contact campaign manager, Cecia
cecia@losnv.com
ALL WELCOME
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Phone number
*
Your answer
Do you live in District E ?
*
Yes
NO
I would like to
host a house party for Tick
Donate to his campaign
Endorse Tick
Clear selection
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Latino Outreach Solutions LLC.
Report Abuse
Forms