|
Please describe an issue/proposed legislative change:
|
|
What are the merits of your position on this issue/proposed
change? |
|
Who do you anticipate supporting or opposing the
issue/proposal? |
|
Do you have any individuals in mind that might be willing to speak on
the issue/proposal?
If yes, Name and contact information: |
|
Submitted by:
Program:
Contact information/or phone number: |
|
Additional Comments: |
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____ I plan to attend the legislative meeting on October 13,
2003
____ I am unable to attend the meeting but would like to be kept
informed on legislative ssues. (If so, please include
your email address and fax number below)
Email address: _________________________
Fax number: ___________________________
|
ICADV
1915 West 18th
Street
Indianapolis, IN. 46202
Phone: 317- 917- 3685 Toll free:
800- 538- 3393
Fax: 317- 917- 3695
Thank you for participating;
please feel free to make additional copies
as needed for your program and
return the surveys by: October 1, 2003
View this page as an Adobe Acrobat (pdf)
file.
View this page as a Microsoft Word document.
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Indiana Coalition Against
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Phone (317)
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