JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Interested in CYD?
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
Your answer
Last Name
Your answer
Phone Number
Your answer
Email
Your answer
Which county do you live in?
Choose
Adams County
Alamosa County
Arapahoe County
Archuleta County
Baca County
Bent County
Boulder County
Broomfield County
Chaffee County
Cheyenne County
Clear Creek County
Conejos County
Costilla County
Crowley County
Custer County
Delta County
Denver County
Dolores County
Douglas County
Eagle County
El Paso County
Elbert County
Fremont County
Garfield County
Gilpin County
Grand County
Gunnison County
Hinsdale County
Huerfano County
Jackson County
Jefferson County
Kiowa County
Kit Carson County
La Plata County
Lake County
Larimer County
Las Animas County
Lincoln County
Logan County
Mesa County
Mineral County
Moffat County
Montezuma County
Montrose County
Morgan County
Otero County
Ouray County
Park County
Phillips County
Pitkin County
Prowers County
Pueblo County
Rio Blanco County
Rio Grande County
Routt County
Saguache County
San Juan County
San Miguel County
Sedgwick County
Summit County
Teller County
Washington County
Weld County
Yuma County
Are 35 years of age or younger?
Yes
No
Clear selection
Are you a student?
High School
Community College
University or College
No
Clear selection
If you are a student, what school do you attend?
Your answer
What issues are most important to you?
All of the Below
Affordable Housing
Campaign Finance Reform
Climate Change and Climate Justice
Criminal Justice Reform
Economic Justice
Education
Gun Violence
Health Care
Immigration
LGBTQ+ Rights
Mutual Aid
Racial Justice
Reproductive Rights
Other:
Would you like to be added to our newsletter?
Yes
No
Clear selection
Do we have permission to share the information you provided here with the leadership of your local chapter? This makes it easier for us to help you get involved in your local politics.
*
Yes
No
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Colorado Young Democrats.
Does this form look suspicious?
Report
Forms