NC100BW-DE Public Policy Request for Advocacy Form
Please fill out the form to alert the National Coalition of 100 Black Women Inc., Delaware Chapter Public Policy Committee of advocacy opportunities for which you would like for us to participate.
Email address *
Name (Last, First) *
Your answer
Is this an urgent request? (An urgent request is defined as a request that requires an immediate action and warrants a response from the Committee in less than 21 days. An immediate action means there is a deadline imposed by an agency/ legislative body). *
If yes, please answer the following questions: Why is the emergency review necessary?
Your answer
What is at stake in terms of anticipated impact?
Your answer
Category *
Describe Advocacy Request *
Your answer
Date Introduced (if applicable)
MM
/
DD
/
YYYY
Bill Number (if applicable)
Your answer
Synopsis of the Bill (if applicable)
Your answer
What organizations have taken a position on this issue (for or against)?
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of University of Delaware. Report Abuse - Terms of Service