RESULTS Groups Outreach Report Form
Great work on engaging with community to keep the power of our advocacy going - we would love to hear more about it! Please share a few details about your outreach activity on the form below.

Contact Karyne Bury ( should you need any additional support or follow up! 
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Email *
What was the date of your event? *
What is your group name?
Who is your Regional Coordinator? *
What type of outreach event was this? *
Did you write letters at this event? *
If so, how many letters did you generate? (Please use numerals.) *
Were other actions taken at the event? If yes, what were they? *
How many total actions were taken at the event? *
How many people attended the event in total? (Please use numbers) *
How many of the attendees were new to your group or RESULTS? (Please use numbers) *
From where did you recruit new people for this event? (Please check all that apply.) *
How many people committed to becoming a group member? *
How many people committed to joining your Action Network? *
How many people committed to becoming a donor?
What was the issue focus of this particular event? *
How do you plan to follow up with the new folks who were part of this event? *
Who filled out this form? *
Optional "Brag Box" - Tell us more about what happened at the event! (And, by the way - terrific job!)
A copy of your responses will be emailed to the address you provided.
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