Name

Organization

Title

Email Address

Work Phone       Other Phone

Address

City & Zip

Have you participated in advocacy and lobbying?          Yes   No

My organization would be interested in (Please choose your top three):

Information on how to build an Advocacy and Lobbying team

Information about Advocacy and Lobbying opportunities

Legislative Reports

Links to informational Web sites and articles

Workshops and seminars

Networking opportunities with other groups

Online lessons about Advocacy and Lobbying