*1.Name (First and Last)(Required.)

2.Was the information ASN provided helpful? Conversely, is there any other information that would have been helpful for you to have?

3.Overall, how was your experience?

*4.Office 1: Please list the congressional office you met with and the date.(Required.)

*5.Office 1: Who did you meet with and what is their contact information?(Required.)

*6.Office 1: Do they support or oppose replacing sequestration with a balanced approach to deficit reduction?(Required.)

*7.Office 1: Does ASN need to follow up with anyone at this office to answer questions or provide further information? (Required.)

*8.Office 1: Did you get pictures from any of your meetings? If so, please forward pictures—with names and titles of everyone in them—to policy@asn-online.org.(Required.)

9.Office 2: Please list the congressional office you met with and the date.

10.Office 2: Who did you meet with and what is their contact information?

11.Office 2: Did they support or oppose replacing sequestration with a balanced approach to deficit reduction?

12.Office 2: Does ASN need to follow up with anyone at this office to answer questions or provide further information?

13.Office 2: Did you get pictures from any of your meetings? If so, please forward pictures—with names and titles of everyone in them—to policy@asn-online.org.

14.Office 3: Please list the congressional office you met with and the date.

15.Office 3: Who did you meet with and what is their contact information?

16.Office 3: Did they support or oppose replacing sequestration with a balanced approach to deficit reduction?

17.Office 3: Does ASN need to follow up with anyone at this office to answer questions or provide further information?

18.Office 3: Did you get pictures from any of your meetings? If so, please forward pictures—with names and titles of everyone in them—to policy@asn-online.org.

19.Is there any additional information you would like to share?