Constituent Testimonial Release Form

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Please answer the below questions and describe your experience with the Office of Congresswoman Robin Kelly.

What is your name? *

What is your email address? *

Which federal agency was our office assisting you with? *

Internal Revenue Service (IRS)

U.S. Citizenship and Immigration Services (USCIS)

Social Security Administration (SSA)

U.S. Department of Veterans Affairs (VA)

U.S. Department of State [Passport or Visa Issue] (DOS)

Small Business Administration (SBA)

United States Postal Service (USPS)

U.S. Department of Defense (DOD)

U.S. Department of Labor (DOL)

U.S. Department of Education (ED)

U.S. Department of Housing and Urban Development (HUD)

U.S. Department of Agriculture (USDA)

U.S. Department of Transportation (DOT)

Office of Personnel Management (OPM)

Other:

Please briefly describe the issue you were seeking assistance with and provide any feedback for our office. *

Where do you live? *

City of Chicago

Cook County

Kankakee County

Will County

How satisfied are you with the help you received from the Office of Congresswoman Robin Kelly? *

Not Satisfied

Very Satisfied

What is the name of the caseworker who assisted you? *

Jazmin Alvarez

Rob Guerrera

Jauwan Hall

Adal Regis

Glennita Williams

Alan Banks

Do Not Remember

Could we share your feedback on Congresswoman Kelly's social media pages or newsletter? If you choose to share your name, you will be identified by first name only. Sharing testimonials helps other constituents learn about the services we offer. *

Yes

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