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Cogswell-Macy Act "I Took Action" Form!
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* Indicates required question
Email
*
Your email
Your Name
*
Your answer
I set up a meeting with my Representative or Senator
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Yes
No, not yet.
Your Zip Code
*
Your answer
Your Role/s
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Parent or Family Member
Teacher of the Deaf and Hard-of-Hearing
Teacher of the Blind and Visually Impaired
Teacher of the Deafblind
Intervener
Interpreter
Orientation and Mobility Specialist
University Faculty Member
Agency Representative
Administrator
Other:
Required
Communities You Represent and Serve
Deaf and Hard-of-Hearing
Blind and Visually Impaired
DeafBlind
All Students with Disabilities
All Adults with Disabilities
Other:
Other People that Attended the Meeting (with the Representative's or Senator's Office)
Your answer
Name of the Representative or Senator
*
Your answer
Name of the Staff Member/s That Attended
*
Your answer
Date of the Appointment
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MM
/
DD
/
YYYY
Describe the Results of the Meeting
*
Your answer
Follow-Up Needed (Questions they had; Other Actions Recommended)
*
Your answer
Did you send a thank-you email?
*
Yes, I did!
No, but I will soon!
I would like another committee member to send one please.
Other actions I have taken include (select all that apply):
Posting a message on my Facebook page
Posting on Twitter and using the #CogswellMacyAct hashtag
Creating a video and posting on YouTube
Writing an email to my Senator and Representative
Recruiting others in my network to support the CMA
Recruited my agency, school, or professional organization to endorse the CMA
Other:
Please share links to your posts or videos that you would like us to know about and share too!
Your answer
Send me a copy of my responses.
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