Grassroots Government Relations Survey
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DHI GRASSROOTS NETWORK INFORMATION SURVEY
(All information will be kept confidential within DHI)

We ask for your support with the DHI's grassroots legislative efforts by filling out the short questionnaire below. Your direct involvement will enable us to create and maintain a strong presence on legislative issues that are of importance to this industry.

1. Please list your past involvement in the political process (e.g. lobby at local/state/federal level; contributor/supporter of local/state/federal elected officials. Please enter N/A if the question does not apply

Please list your past involvement in the political process (e.g. lobby at local/state/federal level; contributor/supporter of local/state/federal elected officials. Please enter N/A if the question does not apply

2. Please identify ANY personal relationships you have with an elected official or former elected official or with their staffs. (e.g. My congressman and I know each other from church, the senator's Chief of Staff and I went to high school together, my children play sports with his children, etc...)

Please identify ANY personal relationships you have with an elected official or former elected official or with their staffs. (e.g. My congressman and I know each other from church, the senator's Chief of Staff and I went to high school together, my children play sports with his children, etc...)

3. Please indicate if you are interested in participating in DHI's Grassroots Network*.

*It is anticipated that DHI’s “Grassroots Network” will function as the government relations action arm of DHI being the first line to develop DHI positions and strategy regarding legislative/regulatory proposals. It will also be responsible for rallying the DHI membership when legislation is being addressed. The Network is likely to have periodic meetings based on the activity level of the DHI’s legislative agenda and the activity on Capitol Hill.

Please indicate if you are interested in participating in DHI's Grassroots Network*. *It is anticipated that DHI’s “Grassroots Network” will function as the government relations action arm of DHI being the first line to develop DHI positions and strategy regarding legislative/regulatory proposals. It will also be responsible for rallying the DHI membership when legislation is being addressed. The Network is likely to have periodic meetings based on the activity level of the DHI’s legislative agenda and the activity on Capitol Hill. Yes

If you have entered information in any of the above three sections where we will need to contact you, please fill in the boxes below. Otherwise, the following information is optional.

4. Please enter your name, company name and company address. (We do not need a company street address)

Please enter your name, company name and company address. (We do not need a company street address) Your Name
Company Name
Company City
Company State
Company Zip Code

5. Please enter your HOME City, State, and Zip Code

Please enter your HOME City, State, and Zip Code Home City
Home State
Home Zip Code

6. Please enter your daytime phone and email.

Please enter your daytime phone and email. Daytime Phone Number
E-mail

Grassroots Government Relations SurveyExit this survey

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Grassroots Government Relations Survey
Exit this survey