Contact Record Form

Each time you complete a legislative contact, with a legislator or staff member, please provide the following information.

Your Information First Name
Last Name
Email Address
Are you a Titan Advocate? Yes
No

Legislative Report Date of Legislative Contact
Contact Name
Title
Legislative Office
Subject (ex. Support SB 569, response to Action Alert)
Type of contact Phone call
Fax
Letter/card
Visit
Other
Outcome

Comments

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