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NAESV District Advocacy Visit Report
This form should be used to report on district meetings with members of Congress or their staff.
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Date of Visit
MM
/
DD
/
YYYY
Your Name
Your answer
Your Program/Coalition Name
Your answer
Your email address
Your answer
Name of Representative or Senator
Your answer
Who did you meet with (list staff names and titles and or indicate if the member was present)?
Your answer
Email of highest ranking staff member at the meeting
Your answer
Issues discussed:
Your answer
Questions asked:
Your answer
Tone of the meeting:
Your answer
Follow up needed:
Your answer
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