Who Do You Know - Staff Member

First Name
Last Name
Home Address
City *
State *
Zip/Postal Code *
Primary Phone
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Data about Relationship with Staff Member:

District of Staff Member:
Name of Staff Member:
Role the Staff Member serves for official:
Staff Member works in the (check one):

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I know him/her (check one)

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What was the frequency of your contact during the past year?
Do you live in the legislator's district?

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Did you personally contribute financially to the legislator's most recent campaign?

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Did you volunteer on the legislator's campaign?

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Do you know someone with a relationship to a legislator or staff person who would be willing to help introduce you or an ASET staff member? Please provide details.

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