Action
Alert!

WDA State Legislator Visit Report Form

ACTION ALERT! (updated 10/15/08)
Fellow Public Policy Advocates,
There currently are no issues to take action on, but remember to remain visible in your community, and in contact with your legislators. Please check regularly for issues needing your action. I urge you to read “On the Pulse” and support other state and national initiatives.
Sincerely,
Angie Wirkus
Public Policy Coordinator,WDA

Directions: Copy and paste the legislator visit report form to the body of an email, complete and email to the WDA office: wda@centurytel.net. Thank you very much!

WDA STATE LEGISLATOR VISIT REPORT FORM
Date of visit:

State Senator:                                                                       Sen. District No.:
      OR
State Representative:                                                           Assembly District No.:

WDA Meeting Participants:
Name Email Address

Who did you meet with?	“X” One:
	Met with legislator only
	Met with staff only; Name of staff member:
	Met with legislator and staff; Name of staff member:

1. What type of visit was this?	" X” one:
	Connection Meeting
	Dietitian Licensure Follow-Up

2. What was the legislator’s/staff’s response to your message?

3. What other issues were raised by the legislator/staff?

4. Who will write a thank you note to the legislator?

5. Is there additional information that the WDA Licensure Committee could provide you with to underscore your message to the legislator?

6. Additional comments or thoughts:

Action Alert!

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