Please complete this form if you only dropped off materials at a congressional office.
Your name:
Your E-mail address:
Your Phone number:
1. Name of legislator and State represented (example: Rep. Christopher Van Hollen - Maryland):
2. Name/names and contact information of ACB Participant(s). Include phone # and email address.
3. ACB Affiliate (if applicable):
4. Name of the congressional staff person you visited:
Check here to indicate you dropped off materials only at a Congressional Office and did not meet with anyone.
Return to legislative seminar packet.
Return to ACB home page.