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​​​​ ​undefined           PROGRAM REGISTRATION

2017 ADVOCACY FORUM AND CAPITOL HILL DAY

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Location
Mary M. Gates Learning Center
701 N. Fairfax Street
Alexandria, VA 22314

Agenda
Tuesday, June 13, 2017:
  • Boot Camp for New Advocates- 8:30 a.m. (registration begins at 8:00 a.m.)
  • Networking Lunch- 12:30 p.m.
  • Program Begins- 1:00 p.m.
  • Optional Dinner Event- 6:30 p.m.

​​Wednesday, June 14, 2017: 8:30 a.m. - 5:30 p.m.

Thursday, June 15, 2017: 7:30 a.m. - 2:30 p.m.


Please find recommended methods of traveling to Alexandria, nearby restaurants, and other attractions you may wish to visit while in Alexandria, VA. There are multiple hotels in the area at which you can get a discounted rate, as well as other nearby alternatives.  
 
 
 
​​​​​​ ​​ATTENDEE INFORMATION​

Required Field*

​If you are a United Way staff or volunteer, you will need to know your United Way organization and Business Performance Matrix segment number. 

​Please ​use this link if you do not know this information.​​​


 UW Organization Number*
 BPM Segment Number*
 I am a*

 First Name*
 Last Name*
 First Name preferred for name badge*
 Title*
Character limit of 30;
please abbreviate if necessary.

 Organization*
 Address Line 1*
 Address Line 2
 City*
 State
 Province
 Postal Code*
 Country*
 Attendee Email*
 Email a copy of confirmation to
 Business Phone*
 Cell Phone
(only for potential urgent matters
during Capitol Hill visits)


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In case of an emergency on-site, ​please provide the following information:

 Emergency Contact Full Name*
 Relationship*
 Day Phone with area code*
 Night Phone with area code*

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