Grassroots Group Questionnaire
Please update the information or add your group to this form. The information will help people who visit our website find your group on our map.
Name of Group: *
Your answer
Zip Code:
Zip Code for the Group's Head Quarters.
Your answer
Is Your Group Still Active: *
Required
If your group is no longer active, would you or someone you know like to be the contact for the Progressive Movement in your area.
If yes, please fill out the main contact information. If no, thank you for your time. You need not go farther.
Group's Acronym:
Your answer
Group's Web Pages:
If more than one URL, you can add more than one by hitting the Enter key after the first entry.
Your answer
Group's Main Contact:
This is the person to contact that has the best overall understanding of the group. Skip if you are the Main Contact.
Your answer
Main Contact's Email Address:
Your answer
Main Contact's Telephone Number:
Your answer
Email Broadcaster:
This is the person that sends emails to your membership.
Your answer
Email Broadcaster Email Address:
Your answer
When does your group meet?
Example: 1st Tuesday of every month at 7pm.
Your answer
Meeting Location:
Example: Madison Library, 111 Test St., Room 201
Your answer
Web I. T. Contact:
This is the person to contact about your presence on the web. You can add more than one by hitting the Enter key after the first entry.
Your answer
Web I. T. Contact Email:
Your answer
Web I. T., Contact Telephone Contact:
Your answer
Anything you would like us to know?
Example: We have Open Mic on the ????? of the month at the ?????. Add a description.
Your answer
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