2021 Absentee Ballot Request – Houston Congregation for Reform Judaism

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Would you like to request an absentee ballot for the 2021 HCRJ Annual Meeting from the secretary of the board?*
- Yes, I would like to request an absentee ballot for the 2021 HCRJ Annual Meeting from the secretary of the board.
Absentee ballots will be sent via email unless otherwise indicated below.*
- I would like to receive my absentee ballot via email.
- I would like to receive my absentee ballot via postal mail and understand I will need to return the paper ballot to HCRJ prior to the annual meeting.
Address to send absentee ballot*
Same as previous

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email address to send absentee ballot*