2017 Grassroots Hill Appointments * 1. Meeting Organizer: * 2. Meeting Organizer Email: * 3. Legislator First Name: * 4. Legislator Last Name: * 5. State: AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY * 6. District (select S for Senate candidate): S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 * 7. Appointment Date and Time: Time MM / DD / YYYY hh : mm AM/PM - AM PM * 8. Meeting Location Building: Cannon Longworth Rayburn Russell Dirksen Hart Capitol Other (please specify) * 9. Meeting Location Room: * 10. Meeting with: Member Staff * 11. If meeting with staff, staff name: * 12. AIA members attending other than meeting scheduler (If more than 4 attending, email attendance list to amandastratton@aia.org): Member 1: Member 2: Member 3: Member 4: * 13. Person responsible for materials pick up: Submit