National Association of Insurance and Financial Advisors

Legislative Contact Form

If you know your member of Congress in the U.S. House or Senate, let us know so we can add you to NAIFA's growing list of politically active agents.

Complete the form below about your relationship with your member of Congress and someone in the APIC Office at NAIFA will get in touch with you.

 

Please provide your contact information:

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Your business address:

     
 
 
 
 
 
       

Your home address:

     
 
 
 
 
 
       
Do you contribute to IFAPAC?:*
   
 
     
Party:  
Are you a member of the following?:  




       

Member of Congress for whom you would like to be NAIFA's grassroots contact:

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Do you know this Member personally?:*  
Please check the items below that describe your relationship with this Member:*











How would this Member describe their relationship with you?*

     
Please provide further information indicating the degree of your relationship with this legislator:
     
Please list other civic, fraternal, university and charitable organizations to which you belong:
   
     
 
Enter security code:
 Security code
   
       
Fields marked with an asterisk (*) are required.