ANHE Advocacy Interest Form

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Thank you for your interest in advocating for healthy people, communities, and planet with the Alliance of Nurses for Healthy Environments (ANHE). This form will help us understand your interests and expertise, your advocacy experience, and where we may be able to utilize your efforts to support ANHE's mission to promote healthy people and healthy environments by educating and leading the nursing profession, advancing research, incorporating evidence-based practice, and influencing policy.

Name *

Credentials *

Email *

Phone Number

Address - Street *

Address - City *

Address - State *

Address - Zip Code *

In a couple sentences, please describe what your interests and expertise include and how they align with ANHE's mission to promote healthy people and healthy environments by educating and leading the nursing profession, advancing research, incorporating evidence-based practice, and influencing policy. *

Would you like to be contacted about participating in the following advocacy efforts? *

Contacting my local, state and/or federal Representative

Submitting a letter-to-the-editor (LTE) or Opinion Editorial (OpEd)

Providing testimony before legislative committees or federal agencies

Giving a presentation on my subject of interest and/or expertise to local, state, or national audience

Submitting a blog post with ANHE

Other:

Required

If you checked "other," please specify:

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