Hill Visit Appointment Form 2018

NELA Lobby Day 2018 Hill Visit Appointment Form

Please use this form to report confirmed Lobby Day 2018 Hill Visits. (Use one form per visit.) Should you have questions or need assistance, please contact Laura M. Flegel at lflegel@nelahq.org or (202) 898-2880, ext. 115.

If the time or location of any confirmed meetings change prior to Lobby Day (April 12), please do not submit a new form. Instead, contact Pedro Valverde at pvalverde@nelahq.org or (415) 296-7629.

Thank you for reporting your scheduled Hill Visits for NELA Lobby Day 2018.

1. Your Name

First Name

Last Name

Email Address

Mobile Phone

2. State Captain (Disregard if you are not assigned to work with a State Captain.)

3. Confirmed Appointment

State
Member Of Congress
Location & Phone

4. If this is not the correct meeting location, please provide the correct location:

5. The Member of Congress is not listed in the drop down.

Appointment With
Location

6. Appointment Time:

8. Name of Congressional staff member who scheduled the meeting:

9. Email address of that staff member (if known): This question requires a valid email address.