Request Form

This form was created to provide a convenient method for requesting quotes for a subscription to our software program or custom count reports. Please begin by reviewing the standard counts reports available at http://www.politicaldata.com/online-counts-reports/. For pricing standard lists and files you can also visit http://www.politicaldata.com/price-calculator/. Please contact your PDI representative with any questions. Count reports and quotes will be sent back to you by email. You may also email your request to one of our consultants.


Your Information





District/City


Scheduled Election Date


Request (Quote/Counts)


Special Instructions/Comments


(Please specify any desired rows/columns)