Meeting Report Congressional Meeting Report Following the meeting with a member of Congress and/or their staff, use this form to document the discussion and follow-up requested. Your Name First Last Your Organization Name Organization Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Email Date of Meeting MM slash DD slash YYYY Meeting Attendees/ ParticipantsNameTitleOrganization/ Office Add RemoveWhat was discussed?What were the highlights of the meeting? What seemed to resonate or be of primary interest to the Member or their staff?Is follow-up needed/requested?YesNoPlease describe what follow up information or activity is expected: If you have a photo from the visit, please upload it here: Drop files here or Select files Max. file size: 50 MB. Please share materials that were provided in the meeting: Drop files here or Select files Max. file size: 50 MB. What's your perception of the Congressional Member/Staff's opinion of the WBC or WBC Program?Strongly Supportive or Very PositiveSupportive or PositiveNeutralUnhelpful or NegativeExtremely Unhelpful or NegativeWhat's your perception of the Congressional Member/Staff's knowledge/familiarity of the WBC or WBC Program?Completely Understands WBC Program Benefits and ChallengesVery KnowledgeableSomewhat UnderstandsDoesn't Seem to Know the ProgramCompletely Unfamiliar, Knows Nothing about the Program Δ
