PV Community Legislative Network
Request to Speak Proxy Form

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Name *
Email Address/User Name *
I understand a member of the Community Legislative Network (CLN) will register the above information in the Request to Speak system at the Arizona State Capitol.  I also understand CLN will retain my email address for purposes of sending Action Alerts. For this reason, we prefer you use a personal email address (versus district). Following registration, I will receive an email from CLN confirming my registration with the Request to Speak system, and I will have to change my password in the system (from pvcln2020) to make it unique.  I understand this proxy form will be maintained for record keeping purposes but it is my responsibility to note my username and password for my records. Type first and last name below as an electronic signature. *
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