Rep. Harris Meeting Request Form

Please complete the following form to request a meeting with Rep. Harris.

Full Name:* First Name:*

Last Name:*

Email Address: *Email: *

Telephone *

Organization name (if applicable)

Please briefly describe the reason for meeting with Rep. Harris. *

If Rep. Harris is unavailable, would you be willing to meet with a staff member on his behalf? *

Yes No

Where would you like the meeting to occur? *

Virtual (Zoom, Teams) In-person (Please specify Harrisburg or Philadelphia)

Comments:

Is this an urgent request? If so, please explain the urgent matter. *