Number of people in you are able to transport in your vehicle?

Do you have a valid drivers license?  yes no

Have your driver's license ever been suspended or revoked?  yes no

Do you have automobile insurance, including personal injury protection?  yes no

What days are you available to transport citizens to polling locations.

Early Voting Days Morning  6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
22-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
23-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
24-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
25-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
26-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
27-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
28-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
29-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
30-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
31-Oct  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
1-Nov  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
2-Nov  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
3-Nov  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
4-Nov  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30
08-Nov  Morning 6:00 -10:00 Noon 9:30- 2:00 Afternoon 1:30 - 5:30 Evening 5:00 - 8:30

What days are you available to be transported to the voting location? Please check all that apply.