APHA International Health Section Advocacy Request Form

1.What is your First and Last Name?(Required.)
2.What is your email address?(Required.)
3.What is the best phone number to contact you?(Required.)
4.Briefly describe the issue you are hoping to advocate for in plain language.(Required.)
5.Please review the 4 main themes described below and select one that most closely represents your issue.(Required.)
6.Which of the 17 UN Sustainable Development Goals (SDGs) does your issue address? (You may select up to 3.)(Required.)
7.Is the target audience APHA or an outside organization?(Required.)
8.What policy statements have already been approved by the Governing Council of APHA that we can cite and use to support our effort?  Refer to APHA's Policy Statement Database (https://bit.ly/2Og0GRH).(Required.)
9.Which advocacy format do you prefer?  More than one format may be applicable.(Required.)
10.What would make your advocacy effort successful in the short-term?(Required.)
11.What would make your advocacy effort successful in the long-term?(Required.)
Current Progress,
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