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* 1. Name?

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* 2. Email?

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* 3. Organization?

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* 4. Job Title?

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* 5. On a scale of 1–5, how comfortable are you with government relations/connecting with your local representatives?
1 = No experience
5 = Very comfortable / experienced

i We adjusted the number you entered based on the slider’s scale.

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* 6. Would you be interested in low-commitment FRP peer support related to connecting with MLAs or government?

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* 7. Are you familiar with our new FRP MLA Toolkit?

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* 8. Has your organization emailed your MLA as part of the FRP Connection Campaign in the past two months?

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