ASCRS Legislator Interaction Form
Use this form to report on interactions (visits, phone calls, fundraisers attended, etc.) you have with your legislators or other elected leaders. Your response will assist ASCRS staff track support for policy initiatives and help formulate strategy. Please be specific as you can about what topics were discussed, including bill numbers if possible, and what action the legislator promised to take, if any. We appreciate your help!
Your Name *
Best email to contact you *
City *
State *
Legislator Contacted *
Please provide first and last name if possible.
How did you interact with your legislator?
Clear selection
Briefly describe your interaction with your legislator
Please provide details on specific issues discussed, including bill number, if applicable.
Did the legislator promise any particular action? If so, what?
i.e.support or oppose a certain bill, sign on to a letter, etc.
Did you promise the legislator that ASCRS would provide him or her with something? *
i.e. if they asked for additional information or bill text
If yes on the above question, please describe actions ASCRS must take.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy