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House District 102 Legislative Request Form
Thank you for contacting the Office of State Representative Ana-Maria Ramos. To receive assistance with a legislative request or event request, please fill out this form. Include a very detailed description of your request to be appropriately addressed. A Team Ramos staffer will contact you as soon as possible with an update regarding your request.

We look forward to assisting you!
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Email *
First Name
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Last Name
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Phone number
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Title -if associated with an organization
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Your address or your organization's address
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Are you a constituent of House District 102?
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Please explain detail why you are contacting the Office of State Representative Ana-Maria Ramos.
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Would you be open to meeting with staff? *
What date would this meeting occur? (Please write out the Date, if there is no date for the request write "N/A") *
Is there a time that you would like to request for this meeting?  (Please write out the Time, if there is no time table for the request write "N/A") *
Please provide the location of the event or the Zoom link Representative Ramos can use to join *
PLEASE CHECK "YES, I UNDERSTAND" IF YOU UNDERSTAND THE FOLLOWING INFORMATION: Submissions that do not include information notifying the Representative's office about the issue to be addressed will not receive a response. You will receive a confirmation from our team as soon as possible that we have received your full submission. This form submission is not a confirmation until you have heard from our office. *
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