Logo

Action Center

State and Local Advocacy Assistance Request Form
You have already submitted a response. You can edit your answers if you wish to review them.

Are you working on a local or state-level advocacy issue and need support? Cure SMA is here to help! Whether you’re new to advocacy or a seasoned advocate, we can assist you in making an impact in your community. Please complete the form below so we can better understand your needs and provide the right support.

Advocacy Issue Details
1.

What issue are you advocating for? 
Briefly describe the state or local issue you're working on and how it impacts the SMA community.

2.

Where is this issue taking place?

3.

Who are the key decision-makers or representatives involved?
Include any names, titles, or government bodies if known.

How Can We Support You?
4.

Select all the ways you'd like support from Cure SMA:

Additional Information
5.

Is there a deadline or upcoming hearing related to your advocacy?
If yes, please provide the date and any details.

6.

Have you already taken any steps on this issue?

7.

If yes, what have you done so far?

8.

Any other information you’d like us to know?
Include links or background that may be helpful.

Please do not close this window. You will need to come back to this window to enter your code.
We just sent an email to ... containing a verification code.

If you do not see the email within the next five minutes, please ensure you entered the correct email address and check your spam/junk mail folder.
Enter Your Info
Your Information
By providing your mobile number, you agree to receive periodic call to action text messages from Cure SMA. Message and data rates may apply. Reply HELP for help. Reply STOP to unsubscribe. Message frequency varies. Privacy Policy  
What is your connection to SMA?
*
What advocacy issues are you interested in?
*
*
*
*
*
*
*
Home Information  
Enter Zip for City and State