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RX Medicare for All
Use this form to indicate your willingness to organize an action during the August congressional recess. You do not have have to have all the details before filling out this form. See
www.pnhp.org/augustrecess
for a running list of actions being planned.
Please contact
organizer@pnhp.org
with any questions.
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* Indicates required question
Your Name (first and last)
*
Your answer
Your email
*
Your answer
Your phone number
*
We will not share your number
Your answer
What is your city?
*
Your answer
What is your state?
*
Your answer
What kind of event do you hope to plan?
*
Organize a delegation to attend a town hall meeting or public forum
Organize an "empty chair" or "sidewalk" town hall meeting
Organize a "House Call" (in-district lobby visit)
Other:
Required
Link to facebook event for your action
(If you have one)
Your answer
Please share a little more information about your event:
*
Please share date/time/location (if you have them), along with any co-sponsors of the event and a brief description.
Your answer
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