Confluence: Policy Pitch Entry Form
Email address *
First Name *
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Last Name *
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Your Organization/Entity/Business *
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Best Daytime Phone *
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Zip Code *
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Describe the problem you would like resolved. (280 characters) *
Your answer
Is the problem a local, state or national issue? *
What research, experience or evidence supports your request for a change? *
Your answer
What do you think needs to happen to resolve the problem? *
Your answer
What impact would occur if the problem is resolved? *
Your answer
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