Please fill out this form for EACH meeting you have scheduled with a member of Congress. Once you submit your first form, you can return to https://www.surveymonkey.com/r/lobbyweek25 to submit additional visit(s) information.

Question Title

* 1. Your Name

Question Title

* 2. Phone Number

Question Title

* 3. Email Address

Question Title

* 4. AFP Chapter

Question Title

* 5. Congressional Office You’re Visiting: (including member of Congress’ name, state and district number if applicable)

Question Title

* 6. Meeting Date

Date

Question Title

* 7. Are You Meeting With (check all that apply)

Question Title

* 8. If Staff, please provide the name and title

Question Title

* 9. How many chapter members are attending?

Question Title

* 10. Please list on separate lines the name and email address (if available) of each chapter member planning to attend

If you have any questions about the form, please email paffairs@afpglobal.org.