Policy Action Network List Thanks for your interest in MNCASA's Policy Action Network. To sign up to receive occasional e-mails about our policy work, please complete this survey. By knowing more about you and your interests, we can tailor the information we send to you. Question Title * 1. First Name Question Title * 2. Last Name: Question Title * 3. E-mail Address: Question Title * 4. What MN Senate District do you live in? (e.g. 58) If you don't know, you can look it up by copying this link and pasting it in in another browser window: http://www.gis.leg.mn/OpenLayers/districts/ Question Title * 5. What MN House District do you live in? (e.g. 58B) If you don't know, you can look it up by copying this link and pasting it in in another browser window: http://www.gis.leg.mn/OpenLayers/districts/ Question Title * 6. Tell us about yourself. (Please check all that apply.) I want to be part of a movement to end sexual violence. I permit MNCASA to list me as supporting sexual violence prevention. I work with people who have been sexually assaulted as a youth or adult. I work with people who have been sexually abused while a child. I work with people who have sexually abused others. I am a parent of a child under age 18. I work with children and/or families. I have a family member or friend who has been sexually abused or assaulted. I know someone who has sexual behavior problems. I was sexually abused in childhood. I was sexually assaulted as an adult. Other (please specify) Question Title * 7. Tell us how you'd like to be involved. Please check all that apply. I would like to receive periodic prevention policy network mailings by e-mail. I am willing to e-mail my elected representatives to ask them to support efforts to prevent sexual violence in Minnesota. I am willing to schedule a meeting with my elected representatives to ask them to support prevention efforts. I am willing to invite my elected representative(s) to join me in attending MNCASA policy events. I attend my precinct caucus and would introduce a sexual violence prevention resolution. I would consider talking about my personal experiences with sexual violence to advocate for prevention with policy makers. I am interested in learning more about MNCASA's prevention policy committee. Please add me to your prevention list serve to receive resources about preventing sexual violence. Other (please specify) Done