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* 1. What is the name of the Member of Congress?

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* 2. What is the name of the congressional staff member that was present?

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* 3. Please check each of the following issues that were discussed:



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* 4. What was the response?

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* 5. What follow-up should be done?
*Note: If a commitment was made to you regarding supporting or co-sponsoring a bill, you should personally follow-up with the legislator or staff.

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* 6. What is your name?

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* 7. Are you a constituent of the Member of Congress you visited?


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* 8. What is your email address?

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* 9. Is there any additional information you would like for ASA's DC office to know?

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* 10. It is important for us to know if a meeting was sought by a constituent and the meeting request was not accommodated by the legislator or his/her staff. Check here if a meeting request was not accommodated.

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