Thank you for hosting an In-District-Meeting with your Member of Congress. We value your feedback and kindly ask that you fill out this form so that we are aware of how your meeting went! Please email membership@unausa.org if you have any further questions and/or concerns.

Question Title

* 1. Your Name

Question Title

* 2. Your email address

Question Title

* 3. Please indicate your UNA-USA Chapter Affiliation or whether you are a Member-at-Large

Question Title

* 4. How many UNA-USA members participated in the meeting?

Question Title

* 5. With which Member of Congress did you schedule a meeting?

Question Title

* 6. Please indicate the name and title of the person with whom you met (e.g. [Congressional Staffer Name], Legislative Aide)

Question Title

* 7. Please indicate the date the meeting occurred

Date

Question Title

* 8. What was the main issue or ask that you discussed during the meeting?

Question Title

* 9. How would you rate the meeting overall?

Question Title

* 10. If applicable, was the Member of Congress interested in co-sponsoring a bill?

Question Title

* 11. Did they ask questions for which you did not have answers? Please explain.

Question Title

* 12. Is there any follow-up that is required by the UNA-USA National Office? Please explain.

T