Elected Officials to Protect America Leadership Council and Task Force Member Form

First Name

Middle Name or Initial (Optional)

Last Name

Suffix (Optional)

Elected Position Title

Additional Titles (ex. Chair, Veterans Affairs)

Elected Municipality or District

Jurisdiction Type (Select from drop down options)*

Term Expiration (Month/Date/Year)

Party Affiliation (Select from drop down options)

Government Role (Select from drop down options)*

Level of Office (Select from drop down options)*

Biography

Mobile or Preferred Phone

Official Address (ex. 1600 Pennsylvania Ave.)

City

Zip Code

Staff Contact Full Name

Staff Contact's Phone Number

Staff Contact's Email

Engagement (Please select all actions you in which you are willing to participate)

National Climate and Energy Security Taskforce (In collaboration with the Department of Energy, EOPA is convening lawmakers, elected tribal leaders, veterans, finance and implementation partners as a taskforce to guide the implementation of the IRA and related funding and support putting climate solutions into action.

Twitter Username

Instagram Username

Facebook Username (enter page URL)

Linkedin Profile (enter page URL)

Profile Photo (Upload Photo for use on EOPA Website

Drop your files here to upload

Full Name