* 1. What date was the meeting?

Date of Meeting:
/
/

* 2. Please fill out the following information.

* 3. Whose office did you visit?

* 6. Who lobbied with you?

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

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

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

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

* 11. Did you discuss historic tax credits?

* 12. Did you discuss the Historic Preservation Fund?

* 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

* 14. Please describe any other topics discussed.

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

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

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

T