Sign On to Extend CHIP Before Funding Expires

Sign On to Extend CHIP Before Funding Expires
Add your organization to show support for the continuation of the Children's Health Insurance Program.
Please note: This is an organizational sign-on letter. Please ensure that you have proper authorization and permission to add your organization to this letter.
Contact first name:*
Contact last name:*
Contact email:*
Please provide the name of your organization exactly as it should appear on the letter. In particular, we ask that you spell out the name of your organization and avoid acronyms.
Organization name: *
As you wish for it to appear on the letter. Please, no acronyms.
Organization city:*
Organization state:*
Please indicate whether your organization is a national organization or state-based organization. To ensure Members of Congress recognize support from their constiuents, we will list national organizations together, and state-based and local organizations together.
Organization scope:*

NationalState or local
Are you authorized to sign on your organization?*

YesNo
We will contact you by email with a final version of the letter once it has been sent to Congressional leadership.
Should be Empty: