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#MyMuslimVote 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 *

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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

I want SMS reminders from #MyMuslimVote *

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I want email reminders from #MyMuslimVote *

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Thank you for pledging to vote.

#MyMuslimVote is a non-partisan voter education and civic engagement led by MPower Change with a coalition of Muslim organizations to register, motivate, and mobilize tens of thousands of U.S. Muslim voters in the general elections and beyond.

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