Sample Letter To A Representative Template Page 2

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Directions for this form
Fill in the blanks with the issues that directly impact your life. Did you receive lifesaving
treatment that you wouldn’t have otherwise been able to afford because of the Affordable Health
Care Act? Has your child faced bullying at school because you come from a family of
immigrants? Share those stories.
What if you don’t think you have a story that would make a difference? You do. You live in this
community. You have the power to vote in the elections that decide the agenda for the state, for
the county, for the nation, and to decide where you tax dollars go. Our representatives don’t get
blank checks – hold them accountable.
If this letter doesn’t quite fit the message you want to send – great! Personalize and write your
own. Find your voice and tell your MoC what is concerning you this week.

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