You must have JavaScript enabled to use this form. Contact Information Name of Organization First Name Last Name Phone Email Meeting Topic and Attendees Topic/Purpose of Meeting: If this meeting is about current legislation please provide the Bill #, author and current location of the bill (if you have that information): Issue to be Discussed-include position represented by attendees: Attendees (Name, title, whom they represent): Date/Time and Location Please provide a couple of dates that you are available to meet Preferred Location of Meeting: Capitol Office District Office Leave this field blank