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Liaison Report Form

Agency

Report includes a conference

Meeting Start Date:*

mm/dd/yyyy

Meeting End Date:

mm/dd/yyyy

Location:

Liaison Name:

Your Email Address:*

Other CTA Representatives:

FAST TRACK - Recommendation(s) - A fast track item is something that must be done within 60 days of your recommendation.

A. Recommendations for Action(s) to be taken by CTA

(Please be specific and give rationale.)

If this recommendation requires fast tracking, check the FAST TRACK box below

Rationale(s):

Continue with additional recommendations and rationale as appropriate, please number consecutively.

B. Brief Summary of Key Topics or areas discussed & actions taken which are of direct importance to CTA (please number consecutively.) How did you utilize the meeting to network, to get CTA’s message out? What was the single most important thing? In listing various item, please number 1, 2 etc. and do not run it all in one paragraph, since it makes it hard to read.

Note: If your report is on pending legislation, please refer to bills by number and author. A brief description of the bill, the group's position on the bill, and the position of CTA.

C. Emerging Issues (Topics you anticipate coming up in the near future)

Note: If your report is on pending legislation, please refer to bills by number and author. A brief description of the bill, the group's position on the bill, and the position of CTA.

Other Instructions:

Attachments- Please forward any attachments by mail to: Liaison Program Coordinator. CTA, 1118 Tenth Street, Sacramento, CA 95814. (Note: you may also use alternative delivery such as scanning documents or faxing documents - fax number is (916) 325-9045).

Conference Request/Confidential Commentary All requests to attend a conference by virtue of your liaison assignment should be sent to - Liaison Program Coordinator.

If you have any questions, please call the liaison program coordinator at (916) 325-1500.

Date of Next Meeting:

Location of Next Meeting:

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