Full Name*

IAEE Chapter

Organization

Mailing Address

Email*

Office number

Cell phone number

Social media profiles (professional or personal)

LinkedIn:

Twitter:

Instagram:

Facebook:

Snapchat:

I have existing relationships with (please provide names below):

Federal officials (U.S. Congress or Senate, executive agencies)State officials (Governor, Lt. Governor, State Senate or House member)Local Officials (Mayor, City Council, County Judge or Commissioner)

Name:

Name:

Name:

Name:

Name:

I have done one of the following in the past (check all that apply):

Hosted a legislator at your exhibitionMet with a legislator (in local district office, in Washington, D.C., etc.)Attended a town hall or community meeting hosted by an elected official/influencerAttended Exhibitions DayPromoted Exhibitions Day within your organizationWritten or called a legislatorServed as a source for media

I’m willing to do one or more of the following in 2020 (check all that apply):

Host a legislator at your exhibitionMeet with a legislator (in local district office, in Washington, D.C., etc.)Attend a town hall or community meeting hosted by an elected official/influencerAttend Exhibitions Day in 2020 (June 2-3, 2020)Promote Exhibitions Day within your organization or chapterWrite or call a legislatorServe as a source for media

Any issues that you are following now/have interest in?