2012 Global Group Report
Thank you for taking actions to create the political will to end hunger and poverty!  Please come back as often as you want to update us on your group's activities.  If you have two actions to report in a particular section (e.g. both an editorial and a letter to the editor) you will need to submit two responses.

PLEASE NOTE:  We have a form specifically designed for reporting face-to-face legislative meetings.  Please report meetings with members of Congress, Senators, or their staff at http://tinyurl.com/2012LobbyReportForm.


Sign in to Google to save your progress. Learn more
For what month are you reporting? *
Scroll to the bottom of the dropdown list to find an option for recording an item from 2011.
Person reporting *
Other than your group name, the questions in this section are not required to complete the form.  Please do come back once a month and update us on the number of active partners, the number in your Action Network, and the details of your monthly group meetings.
Choose your group from the lists below.  If it's not listed, look at the end of the list for your other options.
Number of Activists in Group
Number in Action Network
How many other people take actions, participate in events, and/or contribute to RESULTS?
When did you meet this month?
Describe your first group meeting this month.  Who attended, did you meet in person or via some technology, and what did you do?
Did you meet a second time?
Describe your second group get-together this month.  Who attended, did you meet in person or via some technology, and what did you do?  If your second (or third, or fourth) meeting was also an outreach meeting of some kind, you can report it, instead, in the OUTREACH section of the form.  Thanks!
If you had a face-to-face meeting with a Senator, Representative, or their staff, please don't report it here.  Instead, use the lobby report form.  Please also use the lobby report form for meetings via conference call with members of Congress or their staff.  That will allow us to capture more complete information about those calls. A link is conveniently provided at the top of this form!

Please use the question below to record the many number of other contacts you make via email, letter, fax, phone, web form, etc. to request an action or follow-up on a request.

Number of contacts with Congressional offices other than face-to-face (e-mails, letters, phone calls)
Don't forget, please use the lobby report form to report on face-to-face meetings with Senators, Representatives, or their staff. A link is conveniently provided at the top of this form!
Report outreach events here.  Type of event:
Clear selection
Notes on Outreach Meeting (date, attendees, happenings, outcomes)
Give us the juicy details about your outreach meeting.  With whom did you meet, who attended, what did you do, what outcomes did you produce?
New Partnerships
Did you create relationships with new organizations or grasstop leaders in your community (e.g. National Education Association, TB Controller, local hospital, business leader, etc.)?  Tell us all about it.
Did you hold a fundraising event this month?
Fill us in on the date, type of event, number of attendees, and all the details!
Total Funds Raised
Please remember that if your media work resulted in a tangible product (item in print, published online, or audio or video recording available), send a copy of the item or its URL (link to the web) to Blair Hinderliter (bhinderliter@results.org).  That way, all of RESULTS can use your great work!  Thanks!
What media did you generate this month?
Clear selection
Date of media piece
When did your story run or your meeting take place?
Details of the media
Name of the outlet, title of piece, who in your group worked on this?  If possible, include the URL to the online version of your work!
Number of phone calls made pitching editorials or op-eds
Number of emails sent pitching editorials or op-eds.
And that's not all....
Other Interesting Tidbits from your month!
Who is your Regional Coordinator? *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy