January DSA for Bernie Report Form

January DSA for Bernie Report Form

Use this form to report your chapter's engagement in the DSA for Bernie Independent Expenditure Campaign.
Name *

First Name Last Name
Email *
example@example.com
DSA Chapter *
Chapter Position (If Applicable)
I am Reporting: *

An Upcoming Event to Add to our DSA for Bernie Map and to Share with our Allies The Results of our Work for the Month of January
Instructions

Make a new submission for each individual event. This will make sure that we can share your event on our DSA for Bernie Map and with our allies in NNU, CPD, and Peoples' Action. This will also allow us to track our progress towards our goals in January.
Upcoming Event Type *

Debate Watch Party Tabling for Bernie (in the Community) Tabling for Bernie (at a College Campus) Door to Door Canvass (using VAN) Door to Door Canvass (without VAN)
Upcoming Event Name
Upcoming Event Date

Month Day Year
Date
Upcoming Event Start Time

: Hour Minutes AM/PM Option
Upcoming Event End Time

: Hour Minutes AM/PM Option

Upcoming Event Brief Description (1-2 Sentences)
Upcoming Event Social Media Page
Notes or Other Information About Event
In January, my chapter: (select all that apply) *

Held a Debate Watch Party Tabled for Bernie (in the Community) Tabled for Bernie (at a College Campus) Knocked Door to Door (using VAN) Knocked Door to Door (without VAN) None Yet, But Want to Get Involved
My Chapter holds Bernie Events *

Weekly or More Frequently Monthly We Just Started! None Yet
Resources My Chapter Would Find Useful
My Chapter Held:

A Phone Bank A Door to Door Canvass A Tabling Event A Crowd Canvass
My Chapter:

Uses VAN Does Not Use VAN, But Wants Access Does Not Use VAN, Uses Another Tracker
Total Number of Voter Contact Events In January
Number of Volunteer Shifts
Number of Attempts (Doors or Phones)
Number of Contacts
Number of Positive IDs
Total Number of Debate/Education/Social Events In January
Our Chapter held:

A Debate Watch Party An Educational Event/Town Hall A Social Event A House Party
Number of Events
Number of Attendees
Money Raised
Number of Commitments to Volunteer Shift
Follow-up plan for sign-ups?
Thoughts from your January experience?
Should be Empty:

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Instructions