2021 HNBA Week of Action Interest Form 2021 HNBA WEEK OF ACTION INTEREST FORM Thank you for your interest in the 2021 HNBA Week of Action. Please complete the form below to receive receive information on how to contact your congressional offices, messaging guidance and the social media toolkit. You will receive a confirmation of your submission to your e-mail (be sure to check your junk/spam filter). Name*FirstLast Professional Title:* Company/Organization:* Address of Residence* City State / Province / Region Postal / Zip Code Hometown (if different from above): City State / Province / Region Postal / Zip Code Phone:* Area Code - Phone Number E-mail:* Please indicate your practice area(s) and identify any sub-specialties:* Please select the topics you have most experience in or are most interested in advocating for: *ImmigrationVoting RightsCriminal Justice ReformCOVID ReliefFederal JudiciaryPuerto Rico In what state are you registered to vote?* Are you a U.S. Citizen?*YESNO Are you active military or a veteran?*YESNO Are you an active, dues paid HNBA member?*YESNO Please indicate your category of HNBA membership or professional level that defines you best:AttorneyStudentJudgeOther Please identify any members of Congress and Senators you have significant connections with and describe the connection:Please complete the addition math captcha below. Word VerificationSubmitReset