Online Form

On-Line Contact Card

Organizing is a process, it takes many conversations as we move undecided faculty to becoming supporters, and then move supporters to members, members to activists, activists to leaders. Please take the time to report on your conversations so we can track our progress and know who has been assessed. Thank you.

My name:

My non-employer email address:

My Phone number (cell preferred):

My institution:

The potential members I visited were:

Date

Demographic info on prospect

Name of person I saw:

Department and/or campus:

Building/Room #:

Phone number and email (if not on organizing list already):

Office hours:

Issue(s) or concern(s):

Assessment of visit:

Notes on conversation:

Follow-up needed and plan for following through:

If you have other visits to report on, please fill out form again. candi.churchill@floridaea.org