Grassroots Strategy for Joint
Finance Hearings

It will be important for disability and aging advocates to share strong, coordinated messages at the upcoming Joint Finance (Budget) Committee hearings. This survey will help us connect you with other advocates who are also attending these hearings.

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* 1. Please tell us who you are:

Name:

Address:

City/Town:

State:

ZIP:

Email Address:

Cell Phone for Day of Hearing:

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* 2. Hearing I can participate in:

Brillion Wednesday, March 18

Milwaukee Friday, March 20

Rice Lake Monday, March 23

Reedsburg Thursday, March 26

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* 3. I can attend:

Time I can get there:

Time I need to leave:

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* 4. I want to participate by: (you can choose more than one)

Speaking as part of a panel that will testify (you would speak for just a few minutes and share you time as a group)

Standing behind the panel while they speak

I prefer to testify by myself so I get more time for my points

Sitting with the group planning to speak

Wearing a t-shirt or button if one is provided

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* 5. If I am speaking, I can talk about:

Family Care changes

IRIS changes

ADRC Changes

d. Other

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* 6. If you are someone who would like to testify about changes to long-term care (Family Care, IRIS, ADRCs) please tell us more about who you are (please choose the item that BEST describes you):

Person with a disability who needs LTC

Older adult who needs LTC

Family member of older adult who uses LTC

Family member of person with disability who uses LTC

Employed within the LTC system

Advocate

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* 7. I can take part in a pre-hearing planning call

Yes

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* 8. Best times to participate in a pre-hearing planning call:

Mornings

Afternoons

Evenings

Weekends

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* 9. Media

I am willing to be a media contact (speak to reporters) at the Joint Finance Hearing that I attend.

I am not willing to speak to the media, but I can help reporters connect to others.