Q.1
CONGRESSIONAL MEETINGS: How Many? (leave blank if none)
Be sure to also fill out our "Congressional Meetings report," see link above.
Q.2
MONTHLY ACTION: Did you and your team complete the Monthly Action? How many people did it?
Q.3
LETTERS TO EDITOR PUBLISHED: How Many? (leave blank if none)
Q.4
LETTERS TO EDITOR SUBMITTED: How Many? (leave blank if none)
Q.5
OP-EDs PUBLISHED: How Many? (leave blank if none)
Q.6
OP-EDs SUBMITTED: How Many? (leave blank if none)
Q.7
EDITORIALS GENERATED? How Many? (leave blank if none)
Q.8
RADIO or TV: How Many? (leave blank if none)
Q.9
NEW CONGRESSIONAL CO-SPONSORS: How many did you get to sign on? (leave blank if none)
Q.10
EVENT TABLING: How Many? (leave blank if none)
Q.11
COALITION BUILDING MEETINGS: How Many? (leave blank if none)
Q.12
PRESENTATIONS: How Many? (leave blank if none)
Q.13
ENDORSEMENTS: How Many? (leave blank if none)
Q.14
Any other special acievements?
Q.15
COMMENTS: Please share any other relevant details about what you shared above. Please note, for Congressional Meetings and Media Generated, we would like you to share a more full report on our other surveys.
Q.16
Name:
*
First Name
Last Name
Q.17
City/State
*
City
State