Mobile Voter Outreach Van Request

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Pinal County’s Mobile Voter Outreach van is the first-of-its-kind in Arizona. It will help reach voters in rural parts of the county. To request the Voter Van at an event fill out the form below. Please allow 2-3 business days to receive a response.

Calendar of Scheduled Events

Full Name

Phone Number

Name of Event

Description/Purpose of Event

Describe where you will have the van park. (26 ft long / 8 ft wide / 10 ft 8 in tall)

Name of Organization

Date/Time you would like us to arrive:

Date/Time the van is no longer needed:

If needed more than 3 hours, explain why and how the van being at this event for a longer period will benefit the event, community and Pinal County residents:

What Voter Outreach activities are you requesting?

Voter Registration

Voter Information

Ballot Drop-Off

Early Voting

Will we be required to fill out Application and/or pay a Fee for this event?

Yes

Will we require a special permit to be in the location of the event?

Yes

Is this event public & non-partisan?

Yes

Is there electrical hook-up available?

Yes

Will restrooms be accessible for our staff?

Yes

Comments or Questions:

Request Agreement
*Please note that filling out this form does not confirm the Mobile Voter Outreach Van will be at your event, our attendance at your event is contingent on availability and/or compatibility of event purpose/goal. The Mobile Voter Outreach Van needs to follow polling place guidelines & procedures. Pinal County has the right to refuse attendance and cancel events*

I have read and understand the Request Agreement

Yes

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.