RESULTS Lobby Report Form 2012
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Which member of Congress? *
Your contact information (optional)
What is your state?
Which RESULTS Group are you from? *
Which issues does your group primarily cover?
What was the date of your meeting? *
Format: mm/dd/yy
What kind of follow up is required?
The meeting was:
Clear selection
Who did you meet with?
How would you rate this member of Congress on the Champion Scale?
Which activists, experts, or community members attended the meeting with you?
Name(s) of aide(s) who attended meeting
Which issues did you cover during the meeting?
Describe how the meeting went and what was accomplished.
Who is making this Report?
Who is Your Regional Coordinator? *
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