Legislative Outreach Form

Legislative Outreach Form
Legislative Outreach Form

The purpose of this form is to compile a database of contacts with legislators. If you have more than one contact, please create a separate entry for each. You can reach the USMMA AAF Legislative Outreach Coordinator Brian Foy ’83 at kpadvocacy@alumni.usmma.edu

Affiliation Type
required
First Name:
required
Last Name:
required
Class Year
Preferred Email:
Phone Number
County
required
State:
required
Zip
required
Congressional District
Legislator Type
Legislator First Name
Legislator Last Name
First name of your contact for your Congressman / Senator
Last name of your contact for your Congressman / Senator
Your contact's Email
Your contact's Phone Number
Describe your relationship with the legislator or their staff
Describe recent contact you have had with the legislator (Ex.: email to/from, phone call, form on legislator's website, etc.)
Additional comments: