Q.1
Your Name
*
First Name
Last Name
Q.2
Your City/State
*
City
State
Q.3
Your Email
*
Email
Q.4
Congressional Office Met with
*
Representative
Senator
Q.5
Congressperson's Name
First Name
Last Name
Q.6
From which State is this MOC?
*
Q.7
Meeting Date
MM
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
/
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
YYYY
Q.8
What party are they from?
Democrat
Republican
Independent
Other
Q.9
Where did this Meeting take place?
*
DC Office
Local Office
Public event or forum
Q.10
Location details: (Which office/city?)
Q.11
Did you meet with Member of Congress, a staff member, or both? (If you met with staff members, please list their full names and positions, if known)
*
Q.12
How many people were in your meeting?
Q.13
What bill or issue(s) did you discuss?
*
Q.14
How would you describe their position on the bill(s)?
Q.15
Additional Comments
Q.16
What agreements, if any, did you make with each other?
Become a new co-sponsor
Enroll other members to co-sponsor
Write an Op-ed
Work together in district on issues
Partner on other legislation
Speak at local event
Other