Follow Up/Report Back to UMDF Question Title * 1. Please tell us about you Name: * Address: Address 2: City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code: * Email Address: Phone Number: Question Title * 2. How many of the UMDF's Grassroots Advocacy Efforts did you undertake for the week of February 15-18 2010 One Two Three Question Title * 3. Tell us which of the advocacy efforts you completed during the week of February 15-18th, 2010. Check all that apply. I phoned my Congressman seeking HR 3502 co-sponsorship I phoned my U.S. Senators seeking S. 2858 co-sponsorship. I used the UMDF's Adovcacy Action Center and sent letters. I visited both of my U.S. Senators I visited by Congressman/Congresswoman I visited one of my U.S. Senators Question Title * 4. Did your meeting produce a commitment from the elected official that he/she would agree to cosponsor H.R. 3502 or S. 2858? No, there was no commitment for H.R. 3502 Yes, my Congressman/Congresswoman will cosponsor H.R.3502 No, there was no commitment for S. 2858. Yes, my Senator will cosponsor S. 2858 If yes, tell us who agreed to cosponsor Question Title * 5. Tell us the name and position of the person you met with and their office (ex. Joe Smith, Legislative Aide, Congressman John Public) Question Title * 6. Tell us about your success. If you had a meeting, share the details with us. If you made a phone call, tell us what was said. Question Title * 7. Would you like us to share your comments on our 'Advocacy Successes" Page at umdf.org? Yes, I give you my permission to use my story and name No Other (please specify) Question Title * 8. Does your Visit/Call/Letter require any follow up with the elected official from the UMDF National Office? If so, please tell us who to contact and the information needed. Question Title * 9. Did you undertake any other Advocacy Activities ( asking friends to send letters, make calls or visit)? Please describe: Question Title * 10. The UMDF Is forming a National Advocacy Grassroots Committee to help mobilize our efforts. Would you be interested in being part of this effort? Yes No Question Title * 11. What are the two best ways to communicate with you? (Please indicate only first and second preference) First Preference Second Preference Email Email First Preference Email Second Preference Telephone Telephone First Preference Telephone Second Preference Home Mailings Home Mailings First Preference Home Mailings Second Preference Done >>