ActionNetwork Signup Form

Page 1 Form

To set up your account on ActionNetwork, please fill out the form below.

First Name *This question is required.

Last Name *This question is required.

Title *This question is required.

CWA Local *This question is required.

Other Local Number

Your Email Address *This question is required.

Local Phone Number *This question is required. This question requires a valid number format.

Local Address *This question is required.

What should this group be called? This should be either your local number or what your members will know your local as. *This question is required.

1. Who will be your administrators? Enter up to 3 *This question is required.

Space Cell	Admin Name	Admin Email Address
Admin 1	Admin 1: Admin Name	Admin 1: Admin Email Address
Admin 2	Admin 2: Admin Name	Admin 2: Admin Email Address
Admin 3	Admin 3: Admin Name	Admin 3: Admin Email Address

2. Local Email Address *This question is required. This question requires a valid email address.

3. Does your local have a website or social media? *This question is required.

Provide the links *This question is required.

Website
Facebook
Twitter
Instagram
Other

4. Would you like to have the members from your local who are on our main emailing list added to your list, or would you rather use your own? You can always add to the list that we have. *This question is required.

Additional comments, questions: