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 Request for Support/Involvement of the
Lorenzo Patiño Council of Sacramento

(Online Submission Form) 

This form speeds consideration of any third party request to speak to the Lorenzo Patiño LULAC Council at the Council monthly meeting.  Prior approval to speak is required and the requestor will be notified one way or the other.

Please Note:  Council assistance offered may be different from that requested.  Meeting(s) may be required with requestor before a course of action is agreed to.  We cannot offer legal advice.  Our focus is for a solution that promotes the general welfare, not necessarily that of one individual.

 



Requestor Contact Information:

Date (mm/dd/yyyy):*
First Name:*
Last Name: *
Address1: Address2:
City: State:   Zip Code: 
Phone:* Email:*
Current LULAC
Member? *

Yes      No

If no, enter name of LULAC member
who referred you: 



The Issue/Problem:


Enter one or two words that best describes the Issue:
(e.g., Discrimination, Sexual Harassment, Civil Rights, etc.)*

Parties (individuals & organizations) involved and affected by the Issue*
What LULAC action are you seeking? *
Security Code:  Please enter last two digits of current year*
__________________________
 * Entry required.  Use "n/a" or "unknown at this time", if necessary.