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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your home zip code?  (used to help ID House/Senate Representative)

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* 4. Do  you serve in any government capacity?  If yes, please describe.

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* 5. Do you know government officials at any level (city, county, state, federal) in positions relevant to buildings, engineering or construction, including building officials, school system facility staff, state energy code officials, etc., with whom you would be willing to speak on ASHRAE’s behalf?

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* 6. Are there any upcoming local government issues related to ASHRAE’s areas of expertise that you think the GGAC should address with government officials?  ASHRAE’s public policy priorities for 2018 include energy efficiency in existing buildings, 90.1 updates, refrigerant safety, and air-borne and water-borne hazards (Legionella).

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* 7. Are you interested in joining the chapter’s Grassroots Government Advocacy Committee?  (Help coordinate other government outreach and education efforts and/or serve on chapter's GGAC committee 2018-2019)

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