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: *
Zip Code:
Zip Code for the Group's Head Quarters.
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If your group is no longer active, would you or someone you know like to be the contact for the Progressive Movement in your area.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:
Group's Web Pages:
If more than one URL, you can add more than one by hitting the Enter key after the first entry.
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.
Main Contact's Email Address:
Main Contact's Telephone Number:
Email Broadcaster:
This is the person that sends emails to your membership.
Email Broadcaster Email Address:
When does your group meet?
Example: 1st Tuesday of every month at 7pm.
Meeting Location:
Example: Madison Library, 111 Test St., Room 201
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.
Web I. T. Contact Email:
Web I. T., Contact Telephone Contact:
Anything you would like us to know?
Example: We have Open Mic on the ????? of the month at the ?????. Add a description.
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