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Group Registration Form

"*" indicates required fields

Group Leader Contact Information

Purpose in submitting this form:*

Please choose your reason for submitting this form from the dropdown menu.

Previous Group Name*

How your group previously apppeared on the Indivisible group map.

Group Leader Full Name*

First Last

Group Leader Email Address*

Enter Email Confirm Email

Group Leader Phone*

How should people contact your group?

Group Name*

Please note: we are attempting to standardize our group listing by removing punctuation and adding spaces between words if they are run together.

Group Location Information*

City State Zip Code

Please enter only one zip code. If you cover mutliple zip codes, select the most central zip

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State (sanitized)*

Group Email Address*

Enter Email Confirm Email

An email address is required and will be made accessible to anyone who sees the group map.

Link to Group's Facebook Page

Leave blank if n/a. This Facebook page will be accessible to anyone who sees the group map.

Link to Group's X/Twitter Page

Leave blank if n/a. If you are another platform, please use the Group Website field. This Twitter profile will be accessible to anyone who sees the group map.

Link to Group's BlueSky Page

Leave blank if n/a. If you are another platform, please use the Group Website field. This BlueSky profile will be accessible to anyone who sees the group map.

Group Website

This website will be accessible to anyone who sees the group map. Leave blank if n/a.

Link to Donate to Group

Leave blank if n/a. This donate page will be accessible to anyone who sees the group map when it is updated and should be to a donate page, not a social media profile

Group's Primary Contact Method*

Website

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Display Contact Form

Is your group part of a statewide network?

Yes

This will be used to indicate whether your group is part of a statewide network on the new Indivisible group map. Leave blank if none.

Name of Statewide Network

What Congressional District(s) is your group active in? Example: NY-11, NY-03

Please list as comma-separated list with two letters-two digits. This will be used to indicate which district(s) your group works in on the new Indivisible group.

Is your group friendly to newcomers?*

Yes

This will be used to indicate whether your group is friendly to newcomers on the new Indivisible group map.

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Group Category

Newcomer Friendly

Public Description**

Less than 400 characters, please. This will be public on the group map.

Our group agrees with these five principles:

Remake our democracy. We recognize our democracy was rigged from the start in favor of the white and wealthy. We actively work to realize a shared vision of a real democracy — of, by, and for the people.
Embrace progressive values. We model inclusion, respect, and fairness in all of our actions.
Coordinate and collaborate. We partner with other Indivisible groups on advocacy, elections, and national Indivisible campaigns.
Build a strong and strategic movement. We focus our efforts to maximize our impact, winning progressive policy victories and taking power at the local, state, and federal level.
Nonviolent actions and events. All events and actions will be nonviolent.

By providing your personal email address, you agree to receive group leader email updates from Indivisible. You can unsubscribe at any time by clicking on the Unsubscribe link at the bottom of an Indivisible email.