Political Outreach/Partners Form

Basic Contact Information:
Organization Name:
Primary Contact:
Organization Address:
City:
State:
Zip:
Email:
Phone:
Fax:
Website:
Officers / Leadership:
President
Vice President
Secretary
Treasurer
Legislative Liaison
Primary Campaign Contact
Number of Members
Membership Distribution	Localized Statewide National International
Primary Communication With Members
Newsletter	Type of Format and publication dates
Resources Willing to Donate to the Campaign:
LIST
	Membership lists
	Donor lists
	Newsletter lists
Other
If yes, how will campaign retrieve?
CONTRIBUTIONS
Financial contribution amount
COMMUNICATIONS
	Will place an article from campaign in newsletter and/or on website
	Will place an ad calling for volunteers, donors, supporters, in newsletter
	Will link to campaign website on website
	Will send email or hard copy communication to membership asking them to engage with the campaign (sign up online, volunteer, donate, etc.)
	Our organization name and logo can be used by campaign in any public communications (see attached authorization form)
	Our organization would like to be included as an official member of the Coalition campaign (see attached authorization form)
MEETINGS
	Will send organizations calendar of events to be included in master campaign calendar for visibility and outreach efforts
	Would like to request a speaker from the campaign to attend meetings and educate membership about the issue and how to get involved
	Would like campaign to drop off literature to use at their events (how much lit needed, where and when is drop off point, etc.)
OTHER RESOURCES AVAILABLE TO THE CAMPAIGN