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* 1. Provide your contact information below and a member of NSGC staff will contact you to fulfill your virtual meeting request.

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* 2. Would you like to meet with your House Representative and/or Senators?

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* 3. Who is your Representative in the U.S. House of Representatives?
Find your Rep here.

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* 4. Are you a Program Director?

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* 5. Do you specialize in any practice areas (ex. cancer)? If so, please explain.

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* 6. Please list your general availability:

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