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Please complete one report per visit. If more than one person attends the meeting, please only submit one form for that visit. Please complete the form immediately after your appointment and return it to ACB staff. Completion of this form offers ACB staff vital feedback and information to aid in accomplishing our legislative goals for 2021. If you have issues completing the online survey, please email electronic copies to advocacy@acb.org. Thank you for your participation.

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* Name of ACB Member:

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* Name of ACB Affiliate:

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* Name of Legislator:

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* Name of Congressional Staff Member:

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