The Legislative Coalition
for People with Disabilities

"Citizens Working Together to Improve Public Policy"

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Fast Facts

Visiting Your Legislator?

•Call ahead and make an appointment.

•Be on time.

•Be brief 10-15 minutes.

•Respect their schedules.

•Take a one-page outline or short written fact sheet to remind legislators about your visit and concerns.

More…

Membership

General Information *First Name:
*Last Name:

Email:

*Address:
*City:
State:
*Zip Code:

Home phone:
Work Phone:
Cell Phone:

Check all that apply Consumer:
Parent:
Relative:
Educator:
Provider:
Legislator:
Non-Profit Org.:
Agency or Dept.:
Other:

Organization:
Title:

Primary Disibility Primary Disability (optional):

Age Group I am most interested in advocating for 0-3 years:
3-5 years:
6-22 years:
Adult:

I am interested in the following committees              (Check all that apply)

             Special Education
             School for the Deaf or Blind
             Higher Education
             Early Intervention
             Children's Healthcare
             Medicaid
             Mental Health.
             Services for People with Disabilities
             Rehabilitation

I can help in the following ways              Contact legislator in my area
             Attend LCPD Meetings
             Come to the Capitol
             Serve in leadership
             Write or call other advocates
             Email / Calling Tree
             Area Representative
             Other

House/Senate Districts Senate:
House:

Please Note: In the blanks beside "Senate" and "House", above, please choose the district numbers where you live. If you do not know these district numbers, go to www.le.utah.gov or contact your County Clerk (Call 801-538-1041 to find your County Clerk)

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The Legislative Coalitionfor People with Disabilities

"Citizens Working Together to Improve Public Policy"

Membership

The Legislative Coalition
for People with Disabilities