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KHAN Legislator Engagement Tracker
1.
Enter Your Contact Details
Name
Company
Email Address
Phone Number
2.
When did you meet with the legislator?
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
3.
Who was the legislator you interacted with?
4.
House or Senate?
House
Senate
5.
What region of the state does the legislator represent?
Northwest Kansas
Southwest Kansas
North Central Kansas
South Central Kansas
Northeast Kansas
East Central Kansas
Southeast Kansas
Flint Hills
Douglas County
Shawnee County
Johnson County
Sedgwick County
6.
What type of interaction did you have?
Event
Group Meeting
Presentation
Individual Meeting
Phone Call
Email
Other (please specify)
7.
Please enter details about your interaction (who hosted, what was the legislator's role, focus of the presentation, who requested the interaction, duration)
8.
What was the topic focus of the interaction? (housing, homelessness, etc.)
9.
Summarize the key points discussed during the interaction.
10.
Did you use any KHAN materials? Choose all that apply.
No KHAN materials used
KHAN Take Action
KHAN CoC Handout
KHAN Coordinated Entry Handout
KHAN Causes of Homelessness Handout
KHAN Solutions to Homelessness Handout
KHAN Housing First Handout
KHAN Videos
11.
Describe your overall impression of the interaction (areas of common ground, areas of pushback, more education/follow up needed)
12.
What are your next steps with this legislator? Choose all that apply.
Invite to a KHAN event
Schedule another meeting
Connect with other allies
Provide follow up information
Send me a copy of my responses via email