KHAN Legislator Engagement Tracker Question Title * 1. Enter Your Contact Details Name Company Email Address Phone Number Question Title * 2. When did you meet with the legislator? Date Date Question Title * 3. Who was the legislator you interacted with? Question Title * 4. House or Senate? House Senate Question Title * 5. What region of the state does the legislator represent? Northwest Kansas Southwest Kansas North Central Kansas South Central Kansas Northeast Kansas East Central Kansas Southeast Kansas Flint Hills Douglas County Shawnee County Johnson County Sedgwick County Question Title * 6. What type of interaction did you have? Event Group Meeting Presentation Individual Meeting Phone Call Email Other (please specify) Question Title * 7. Please enter details about your interaction (who hosted, what was the legislator's role, focus of the presentation, who requested the interaction, duration) Question Title * 8. What was the topic focus of the interaction? (housing, homelessness, etc.) Question Title * 9. Summarize the key points discussed during the interaction. Question Title * 10. Did you use any KHAN materials? Choose all that apply. No KHAN materials used KHAN Take Action KHAN CoC Handout KHAN Coordinated Entry Handout KHAN Causes of Homelessness Handout KHAN Solutions to Homelessness Handout KHAN Housing First Handout KHAN Videos Question Title * 11. Describe your overall impression of the interaction (areas of common ground, areas of pushback, more education/follow up needed) Question Title * 12. What are your next steps with this legislator? Choose all that apply. Invite to a KHAN event Schedule another meeting Connect with other allies Provide follow up information Done
