State and Local Government Leadership

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We are using this form to collect information on State and Local government entities who would like to take action to support Afghans, the Afghan Adjustment Act, and / or the volunteers working to help.

This is meant for state and local government leaders in the United States only

First name *

Last name *

Email *

City *

State or Province *

Country *

Postal Code *

Name of government entity or organization *

Title

Your title

Please describe your role *

Elected official

Appointed Official

Staff

Constituent

Type of entity

Please indicate what type of government entity or organization you represent

State

City or Town

County (or equivalent)

Special District (Airport, Port, Transit, Water, or other)

Labor union

Chamber of Commerce or other business group

Other:

Clear selection

Are you an employee of the entity or organization listed here?

Yes

Clear selection

Are you authorized to speak on behalf of your organization?

Yes

Clear selection

What ways are you willing to support the efforts of AfghanEvac?

Draft resolutions from our organization or government entity

Lighting civic infrastructure

Writing OpEds

Media interviews

Social media

Honor volunteers in your jurisdiction for their efforts

Advocate with other elected or appointed leaders

Submit

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