#MyMuslim Vote Pledge Form Please fill out the following form with your contact info and what your #MyMuslimVote is for! Name * First Name Last Name Date of birth * Email * Phone * (###) ### #### Zipcode * What location did you learn about this pledge form? Please share if which voter registration drive, event, online source or person that shared this form with you. #MyMuslimVote is for: (Pick all that apply) Healthcare For All Civil and Voting Rights Economic Justice Immigrant Rights Combatting Islamophobia Climate Justice Foreign Policy I want SMS reminders from #MyMuslimVote * Yes No I want email reminders from #MyMuslimVote * Yes No THANK YOU! Your pledge to vote today brings us one step closer to building long term political governing power for our communities!
