Thank you for taking the time to fill out this survey! We appreciate your input into ways that the Texas Campaign can serve as a resource to regional adolescent health coalitions. If you have any questions, please contact Melanie Chasteen at melanie@txcampaign.org, or 512-791-5110.

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* 1. Please provide contact information for yourself. Providing your home address is optional, but it will help us connect you with appropriate elected officials for advocacy.

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* 2. What topics are you personally interested in?

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* 3. (Optional) Please provide your employer information

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* 4. On March 2 - 5, 2021, the Texas Campaign will be holding a virtual "Advocacy in Action" week where we will meet with stakeholders and election officials. We are currently recruiting regional leads and advocates to participate in this event. Training will be provided. 

Are you interested in participating in this event? The total time commitment would be approximately 2 hours as an advocate and 5 hours as a regional lead.

The next few questions will ask about the teen pregnancy prevention coalition you work with. If you do not currently work with such a coalition, you can skip to the end of the survey and hit submit.

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* 5. Do you represent or belong to a teen pregnancy prevention or adolescent health coalition? If so, please provide the Coalition name:

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* 6. What county, area, or region does your coalition serve?

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* 7. How active would you say the coalition is? 

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* 8. The Texas Campaign is assessing services we can provide to regional coalitions. Please let us know how useful the following services would be to your coalition:

  Not very useful  Somewhat useful Very useful
Advocacy training 
Advocacy updates, such as tracking relevant legislation 
Updates on funding or grant opportunities 
Help implementing local policy change around topics such as district-level sex education 
Convening with other teen pregnancy prevention coalitions statewide 
Providing local data on topics such as teen births 
Training for area clinicians
Training for area educators 

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* 9. Are there other services you would like the Texas Campaign to provide?

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