Full Name:

Email Address:

Home Address:

Are you a resident of the Christina School District?   No Yes

Note: you do not have to be a resident of the Christina School district to sign this petition.

Are you an employee of the Christina School District?   No Yes

Note: if you are concerned about retaliation by the district, please contact your union.

What is your political affiliation?     Select one Democrat Republican Independent Not a Registered Voter Other

Are you currently employed in or retired from an education related career?     Select one No Yes

If yes, what is your job title?

1. Do you believe that zero tolerance policies should be used in schools?     Select Yes No

2. Would you support a state law banning zero-tolerance policies in publicly funded schools? Select Yes No

3. Would you support a federal law banning zero-tolerance policies in publicly funded schools?   Select Yes No

4. Do you believe that school districts that knowingly make choices that will psychological, emotionally, or physically harm children should be held liable for those choices?   Select Yes No