Congresswoman Michele Bachmann. Proudly Serving the 6th District of Minnesota

Name:

* Prefix	* First Name	* Last Name

* Address:

* City:

* State:

* Zip:

* Point of contact:

* Phone:

* Email:

Desired meeting location:

DC District

Will anyone from
Minnesota be attending
this meeting?

Yes No

If so Who?

What is your connection with the Minnesota:

Which issue/area of specialty does this meeting concern:

Are you seeking meeting with the Congressman, one of his staffers, or either:

Preferred date/time:

Alternate date/time:

PURPOSE of meeting including any specific BILL NUMBERS:

Washington Office
- 107 Cannon HOB
- Washington, DC 20515
- Phone: (202) 225-2331
- Fax: (202) 225-6475
Woodbury Office
- 6043 Hudson Rd, Suite 330
- Woodbury, MN 55125
- Phone: 651-731-5400
- Fax: 651-731-6650
St. Cloud/Waite Park Office
- 110 2nd Street S, Suite 232
- Waite Park, MN 56387
- Phone: 320-253-5931
- Fax: 320-240-6905

Congresswoman Michelle Bachmann. Proudly Serving the 6th District of Minnesota