Tell Us A Little About You

Thanks for joining the National Political Do Not Contact Registry.

If you have a moment, we would like to find out a little bit about who you are.

This information is being collected at an aggregate level for the NPDNC staff to understand at a summary level who is registering and where they are learning about us.

You are under no obligation to fill this out.

How Did You Hear About Us? (Friend, newspaper, radio, tv, internet,) and in Which Media Outlet (Name of paper, radio station, tv station, internet site).

In which state do you reside?

What is your gender?

	Male
	Female

What is your age (range)?

	18-25
	26-34
	35-44
	45-54
	55-64
	65-74
	75-84
	85-

About how many automated political phone calls do you receive EACH day during an election season?

	0 - 4
	5 - 9
	10 - 14
	15 -

Does receiving automated political calls influence your decision to vote?

	Yes
	Sometimes
	No

What Would You Like to Tell Politicians About Robocalls? How have they impacted your life? (keep it clean! Remember, personal accounts are very powerful in influencing elected officials)

Is There Anything We Could Do To Make The Process Of Registering On This Site Easier, What Can We Improve?

Type the letters and numbers you see in the image:

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