List Your Current Group/Free Agent Members, Contact Information, and Group Role(S)

List Your Current Group/Free Agent Members, Contact Information, and Group Role(s)

Our group is located in ______(city and state). Our group covers the following congressional district(s) (e.g. CA-03): ______.

Please list ALL the members of your group below.Please make sure the crucial roles listed below are assigned for your group. If you are a Free Agent (solo advocate), what role/skill most interests you?For other fun and useful roles, go to:

Activist Name(s) / Email / Phone # / Role(s) in Group
Group Leader
Group Leader
Senator #1 Point Person
Senator #2 Point Person
Representative #1 Point Person
Representative #2 Point Person
Media Point Person
Action Network Manager

Contact information for the RESULTS Website Directory

Group Contact Name: / Phone:
Group E-mail*: / Phone:
Group Facebook URL: / Group Website URL:

Other information:

* We strongly encourage your group to set up a separate group e-mail to list on the website (). This allows some continuity in case your contact person changes.RESULTS 2016 Group Plan Summary Group Name: ______

1. Our Group Norms

What “norms” do we want to set for our group this year? Norms can include attending meetings twice per month, sharing leadership, having fun, creating a space where people feel comfortable to share, welcome new members, etc.

1. / 5.
2. / 6.
3. / 7.
4. / 8.

2. Our 2016 Goals

Group Sustainability and Growth
Monthly Meeting dates, times locations / 1st meeting ______2nd meeting ______
Advocates / Current # in group: ______# we want by the end of 2016: ______
Outreach / # of outreach meetings in 2016? ______Approximate dates: ______
2016 RESULTS International Conference (June 25-28) / # of group members who’d like to attend: ______
Names:
Fundraising / Fundraising goal: $______Date (approx.): ______
Type (circle): Event Friends & Family Other: ______
Local Action Network / Current # of people in our Local Action Network: ______
# we want in LAN by the end of 2016: ______
Regional Conferences / Our group would attend a RESULTS Regional Conference (circle): Yes No
We prefer it take place (time of year): ______
We’re willing to travel ______miles for a Regional Conference.
Meeting with Members of Congress
Senator #1 Name:______Point Person: ______1st Mtg Request (date): ______
Senator #2 Name:______Point Person: ______1st Mtg Request (date): ______
Rep #1 Name:______Point Person: ______1st Mtg Request (date): ______
Rep #2 Name:______Point Person: ______1st Mtg Request (date): ______
Working with the Media
We want to generate ______editorials, ______op-eds, ______letters to the editor, and ______articles in 2016. We will work with the following newspapers:
We’d also like to generate other media, e.g. TV, blogs, web articles: List ideas: