Release Chantal! Legislative Visit Report Form
Thank you for taking action and engaging your legislators in the campaign to surface Chantal!

Please fill out this form after you have conducted lobby visits, phone calls, or email engagement with your legislators. ICHRP-US, Malaya Movement, and the PHRA Coalition will use the information you provide to track legislative engagement and to aid in developing next steps for the campaign.
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Name (First name, last name) *
Email *
Organization or affiliation
City, State *
Name of Legislator engaged *
If not Legislator, name of Staffer of Legislator
Contact Information of Staffer of Legislator
Date of Visit or Engagement *
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DD
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What did the legislator commit to support?
Please describe how the visit, phone call, or email engagement went. *
Who attended the visit (on your side and which staffers)? How was the interaction with the legislator? What were the main points of discussion or feedback from the office? What was helpful during the visit? etc.
Recommendations for further engagement with legislator *
Additional questions or comments
Submit
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