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* 1. What date was the meeting?

Date of Meeting:

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* 2. Please fill out the following information.

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* 3. Whose office did you visit?

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* 6. Who lobbied with you?

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* 7. Who did you meet with? Please include the name and title of all who attended.

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* 8. Is he/she a member of the Congressional Historic Preservation Caucus?

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* 9. If not, would he/she be interested in joining the Preservation Caucus?

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* 10. In your meeting, did you discuss transportation legislation?

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* 11. Did you discuss historic tax credits?

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* 12. Did you discuss the Historic Preservation Fund?

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* 13. Please give your impression of the representative or staff member's attitude toward the following preservation issues.

  Stongly supportive Supportive Neutral Unsupportive Very unsupportive Unknown
Transportation Enhancements
Historic Tax Credits
HPF

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* 14. Please describe any other topics discussed.

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* 15. Is follow-up with this person necessary?

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* 16. Did you promise that Preservation Action would contact or provide additional information to this person?

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* 17. Are you aware of any specific preservation issues in this representative's district?

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