contact-congress/members/M001169.yaml

bioguide:  M001169
contact_form:
  method: post
  action: "https://www.murphy.senate.gov/contact"
  steps:
    - visit: "http://www.murphy.senate.gov/contact"
    - javascript:
        - value: document.querySelector('.SiteLayout__main').innerHTML = '<div id=\"form-FE378C8B-ECA5-FC96-D7EE-18EE82AE3ABD\" class=\"amend-form-container loaded\"><form id=\"FE378C8B-ECA5-FC96-D7EE-18EE82AE3ABD\" action=\"https://www.murphy.senate.gov/contact\" method=\"post\"><div class=\"control-group\"><label class=\"control-label\" for=\"issue-type\">Message Topic<span class=\"required\">*</span></label><div class=\"controls\"><select id=\"issue-type\" name=\"input_0ABBAE0C-9635-FF04-6478-C0D0714750A0\"><option value=\"\">Please select a topic</option><option value=\"Academy Nominations\">Academy Nominations</option><option value=\"Adoption\">Adoption</option><option value=\"Aging and Seniors\">Aging and Seniors</option><option value=\"Agriculture\">Agriculture</option><option value=\"Animal Rights\">Animal Rights</option><option value=\"Arts, Museums and Humanities\">Arts</option><option value=\"Budget\">Budget</option><option value=\"Campaign Finance\">Campaign Finance</option><option value=\"Casework\">Casework</option><option value=\"Child Welfare\">Children and Family</option><option value=\"Civil Rights\">Civil Rights and Racial Equity</option><option value=\"Environment\">Climate Change and the Environment</option><option value=\"Commemorative/Congratulatory\">Commemorative/Congratulatory</option><option value=\"Commerce\">Commerce</option><option value=\"Crime\">Crime</option><option value=\"Defense &amp; Military\">Defense</option><option value=\"Disabilities\">Disability Rights</option><option value=\"Education Higher\">Education Higher</option><option value=\"Education K through 12\">Education K through 12</option><option value=\"Energy\">Energy</option><option value=\"Financial Services\">Financial Services</option><option value=\"Foreclosures\">Foreclosures</option><option value=\"FORAFFS\">Foreign Affairs</option><option value=\"Government Ethics\">Government Ethics</option><option value=\"Government Reform\">Government Reform</option><option value=\"Gun Violence Prevention\">Gun Violence Prevention</option><option value=\"Health Reform\">Health</option><option value=\"Health Insurance/ACA\">Health Insurance</option><option value=\"Homeland Security\">Homeland Security</option><option value=\"Human Trafficking\">Human Trafficking</option><option value=\"Illegal Drugs\">Illegal Drugs</option><option value=\"Immigration Reform\">Immigration</option><option value=\"Intellectual Property/Patents\">Intellectual Property/Patents</option><option value=\"Parks, Monuments &amp; Public Lands\">Interior/Forestry</option><option value=\"Internships\">Internships &amp; Senate Page Program</option><option value=\"Jobs\">Jobs</option><option value=\"Judiciary\">Judiciary</option><option value=\"Labor\">Labor</option><option value=\"LIHEAP\">LIHEAP</option><option value=\"Medicare\">Medicare/Medicaid</option><option value=\"Mental Health\">Mental/Behavioral Health</option><option value=\"Military\">Military</option><option value=\"Native Americans\">Native Americans</option><option value=\"Pensions\">Pensions</option><option value=\"Postal\">Postal</option><option value=\"Prescription Drugs\">Prescription Drugs</option><option value=\"Choice &amp; Womens Health\">Women\'s Issues/Reproductive Rights</option><option value=\"Presidential Greetings\">Presidential Greetings</option><option value=\"Science\">Science and Space</option><option value=\"Small Business\">Small Business</option><option value=\"Social Security\">Social Security</option><option value=\"Taxes\">Taxes</option><option value=\"Telecommunications\">Telecommunications</option><option value=\"Tobacco\">Tobacco</option><option value=\"Tours and Tickets\">Tours and Tickets</option><option value=\"Trade\">Trade</option><option value=\"Transportation\">Transportation</option><option value=\"Veterans\">Veterans</option><option value=\"Welfare/Food Stamps\">Welfare/Food Stamps</option><option value=\"Other\">Other</option></select></div></div><style> .js-displays </style><div id=\"academy-nominations\" class=\"mt-2 js-displays\">I am honored to nominate bright young men and women from Connecticut as candidates to the U.S. Military, Naval, Air Force and Merchant Marine Academies.<p class=\"mt-2\">Please visit my <a class=\"Link\" href=\"/services/academy\">Academy Nominations page</a>.</p></div><div id=\"casework\" class=\"mt-2 js-displays\">I am happy to help if you are having an issue with a federal agency. Please visit my Help with a Federal Agency page.<p class=\"mt-2\"><a class=\"Link\" href=\"/services/help\">Help with a Federal Agency</a></p></div><div id=\"commemorative-congratulatory-memorative\" class=\"mt-2 js-displays\">If you would like me to write a letter of condolence to a Connecticut resident, please visit my Special Recognitions page.<p class=\"mt-2\"><a class=\"Link\" href=\"/services/special-recognitions\">Special Recognitions</a></p></div><div id=\"internships\" class=\"mt-2 js-displays\">If you are interested in learning more about internships in one of my offices, please visit my Internships page.<p class=\"mt-2\"><a class=\"Link\" href=\"/services/internships\">Internships</a></p></div><div id=\"tours-and-tickets\" class=\"mt-2 js-displays\">If you are visiting DC and need help with a tour, please use my Visiting DC page.<p class=\"mt-2\"><a class=\"Link\" href=\"/services/visiting\">Visiting DC</a></p></div><div id=\"contact-form\"><div class=\"control-group\"><div class=\"controls\"><input id=\"prefixfield\" name=\"input_AB325C8C-EFA8-001B-B51C-2471B8E05D44\" type=\"hidden\"></div></div><fieldset><legend>Your Contact Information</legend><div class=\"control-group\"><label class=\"control-label\" for=\"prefixtoggle\">Prefix<span class=\"required\">*</span></label><div class=\"controls\"><select id=\"prefixtoggle\" name=\"input_021E6782-96D4-5780-E206-014F5E35C3F8\"><option value=\"\">--</option><option value=\"Mr.\">Mr.</option><option value=\"Ms.\">Ms.</option><option value=\"Mrs.\">Mrs.</option><option value=\"Miss\">Miss</option><option value=\"Mx.\">Mx.</option><option value=\"Dr.\">Dr.</option><option value=\"Father\">Father</option><option value=\"Imam\">Imam</option><option value=\"Professor\">Professor</option><option value=\"Reverend\">Reverend</option><option value=\"Rabbi\">Rabbi</option><option value=\"Sister\">Sister</option><option value=\"The Honorable\">The Honorable</option><option value=\"NONE\">No Prefix</option></select></div></div><div class=\"row\"><div class=\"col-12 col-md-4\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-0D9C1CBF-0FA9-F521-7BE3-D60FBF8BC532\">First Name<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-0D9C1CBF-0FA9-F521-7BE3-D60FBF8BC532\" name=\"input_0D9C1CBF-0FA9-F521-7BE3-D60FBF8BC532\" type=\"text\" placeholder=\"Required\"></div></div></div><div class=\"col-12 col-md-4\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-021E6808-E024-5908-3F8C-F3A903888D3B\">Middle Name</label><div class=\"controls\"><input id=\"input-021E6808-E024-5908-3F8C-F3A903888D3B\" name=\"input_021E6808-E024-5908-3F8C-F3A903888D3B\" type=\"text\"></div></div></div><div class=\"col-12 col-md-4\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-021E6848-A43A-487E-E67F-09444047A2BC\">Last Name<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-021E6848-A43A-487E-E67F-09444047A2BC\" name=\"input_021E6848-A43A-487E-E67F-09444047A2BC\"  type=\"text\" placeholder=\"Required\"></div></div></div></div><div class=\"control-group\"><label class=\"control-label\" for=\"input-02A611A6-C6E3-A8FD-5992-EE40147D726A\">Street Address<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-02A611A6-C6E3-A8FD-5992-EE40147D726A\" name=\"input_02A611A6-C6E3-A8FD-5992-EE40147D726A\"  type=\"text\" placeholder=\"Required\"></div></div><div class=\"control-group\"><label class=\"control-label\" for=\"input-02A611E7-D86B-7139-AD0F-692B62A62CD2\">Street Address (2)</label><div class=\"controls\"><input id=\"input-02A611E7-D86B-7139-AD0F-692B62A62CD2\" name=\"input_02A611E7-D86B-7139-AD0F-692B62A62CD2\" type=\"text\"></div></div><div class=\"row\"><div class=\"col-12 col-md-4\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-02A61225-E09F-EA85-FAF0-D225ED392435\">City<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-02A61225-E09F-EA85-FAF0-D225ED392435\" name=\"input_02A61225-E09F-EA85-FAF0-D225ED392435\" type=\"text\" placeholder=\"Required\"></div></div></div><div class=\"col-12 col-md-4\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-02A61263-CB93-EA3B-18F7-572F08EA57F4\">State<span class=\"required\">*</span></label><div class=\"controls\"><select id=\"input-02A61263-CB93-EA3B-18F7-572F08EA57F4\" name=\"input_02A61263-CB93-EA3B-18F7-572F08EA57F4\" ><option value=\"\">--</option><option value=\"AL\">AL</option><option value=\"AK\">AK</option><option value=\"AR\">AR</option><option value=\"AZ\">AZ</option><option value=\"CA\">CA</option><option value=\"CO\">CO</option><option value=\"CT\">CT</option><option value=\"DC\">DC</option><option value=\"DE\">DE</option><option value=\"FL\">FL</option><option value=\"GA\">GA</option><option value=\"HI\">HI</option><option value=\"ID\">ID</option><option value=\"IL\">IL</option><option value=\"IN\">IN</option><option value=\"IA\">IA</option><option value=\"KS\">KS</option><option value=\"KY\">KY</option><option value=\"LA\">LA</option><option value=\"ME\">ME</option><option value=\"MD\">MD</option><option value=\"MA\">MA</option><option value=\"MI\">MI</option><option value=\"MN\">MN</option><option value=\"MS\">MS</option><option value=\"MO\">MO</option><option value=\"MT\">MT</option><option value=\"NE\">NE</option><option value=\"NV\">NV</option><option value=\"NH\">NH</option><option value=\"NJ\">NJ</option><option value=\"NM\">NM</option><option value=\"NY\">NY</option><option value=\"NC\">NC</option><option value=\"ND\">ND</option><option value=\"OH\">OH</option><option value=\"OK\">OK</option><option value=\"OR\">OR</option><option value=\"PA\">PA</option><option value=\"RI\">RI</option><option value=\"SC\">SC</option><option value=\"SD\">SD</option><option value=\"TN\">TN</option><option value=\"TX\">TX</option><option value=\"UT\">UT</option><option value=\"VT\">VT</option><option value=\"VA\">VA</option><option value=\"WA\">WA</option><option value=\"WV\">WV</option><option value=\"WI\">WI</option><option value=\"WY\">WY</option></select></div></div></div><div class=\"col-12 col-md-4\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-02A612A3-005B-4DF1-0308-92EB04712239\">Zip<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-02A612A3-005B-4DF1-0308-92EB04712239\" name=\"input_02A612A3-005B-4DF1-0308-92EB04712239\" type=\"text\" placeholder=\"Required\"></div></div></div></div><div class=\"control-group\"><label class=\"control-label\" for=\"input-02C9EBF2-9068-15B3-76C7-3DFE96C5D370\">Phone Number</label><div class=\"controls\"><input id=\"input-02C9EBF2-9068-15B3-76C7-3DFE96C5D370\" name=\"input_02C9EBF2-9068-15B3-76C7-3DFE96C5D370\" type=\"text\"></div></div><div class=\"row\"><div class=\"col-12 col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"email\">Email<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"email\" name=\"input_02D398B4-9987-B172-DEA3-3191E1F79BE8\" type=\"text\" placeholder=\"Required\"></div></div></div><div class=\"col-12 col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-02D398F5-DCDB-34E1-6593-048598518F1D\">Verify Email<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-02D398F5-DCDB-34E1-6593-048598518F1D\" name=\"input_02D398F5-DCDB-34E1-6593-048598518F1D\" type=\"text\" placeholder=\"Required\"></div></div></div></div></fieldset><fieldset><legend>Your Message</legend><div class=\"control-group\"><label class=\"control-label\" for=\"input-02E0E441-9477-3987-8977-A4EC9BDD0DBD\">Please enter the subject of your message<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-02E0E441-9477-3987-8977-A4EC9BDD0DBD\" name=\"input_02E0E441-9477-3987-8977-A4EC9BDD0DBD\" type=\"text\" placeholder=\"Required\"></div></div><div class=\"control-group\"><label class=\"control-label\" for=\"input-02E45FD5-BD42-AF0E-8834-08C8C725558F\">Comments<span class=\"required\">*</span></label><div class=\"controls\"><textarea id=\"input-02E45FD5-BD42-AF0E-8834-08C8C725558F\" name=\"input_02E45FD5-BD42-AF0E-8834-08C8C725558F\"></textarea></div></div><div><p class=\"mb-4\">Fewer than 10,000 characters</p></div><div class=\"control-group\"><div>Would you like to know when I’m near your area holding a town hall or community event?</div><div class=\"controls\"><div id=\"town-hall\" name=\"input_03C3FEAA-D043-3E98-4120-C55D4E189D16\"><div><div class=\"checkbox-container\"><input type=\"radio\" id=\"town-hall-0\" name=\"input_03C3FEAA-D043-3E98-4120-C55D4E189D16\" value=\"03C3FF1C-F1C3-092C-EEDE-2245E9A63E83\"><label for=\"town-hall-0\">Yes</label></div><div class=\"checkbox-container\"><input type=\"radio\" id=\"town-hall-1\" name=\"input_03C3FEAA-D043-3E98-4120-C55D4E189D16\" value=\"03C511B2-FF33-DDF3-C032-07DF65083425\" checked=\"\"><label for=\"town-hall-1\">No</label></div></div><div></div></div></div></div><div id=\"affl-container\" class=\"d-none\"></div></fieldset></div><div><input type=\"hidden\" id=\"creativengine-form-identifier\" name=\"creativengine_form_identifier\" value=\"FE378C8B-ECA5-FC96-D7EE-18EE82AE3ABD\"><input type=\"hidden\" id=\"email-address-validation-field\" name=\"email_address_validation_field\" value=\"\"></div><div class=\"control-group\"><div class=\"controls\"><button type=\"submit\" class=\"btn\">Submit</button></div></div></form></div>'
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