1.Contact Information

Name

Organization

City/Town

State/Province

Email Address

2.Please indicate actions you would like to take to support federal advocacy.

At least 3 district visits in a year with at least one federally elected official

Local action alert(s) on federal policy issues

At least one "show Congress" event in a year

Work with local partners to put pressure on at least one federally elected official

Work with at least one local elected official to weigh in with at least one federally elected official

I cannot commit to any action, but continue to ask me for funding

I cannot commit to any action or funding, but continue to inform me of Bike Walk Action needs

Other (please specify)