March of Dimes Tennessee Chapter Advocacy Day

2014 Advocacy Day Registration

 
Please fill out the information below to register to attend our 2014 Advocacy Day in Nashville.

OUR EVENTS: See event flyer on our website. Event specifics will be sent to registered participants.

* ADVOCACY DAY: Tuesday, March 18th from 8:30am-3pm CST.
* LEGISLATIVE RECEPTION: Monday, March 17th, 5:30-7:30pm CST.
* CONFERENCE CALL TRAINING: Thursday, March 13th from 1-2pm CST/2-3pm EST.

We hope you will be one of our advocates this year! This will be a rewarding day to advocate to our legislators about issues concerning the health of women, infants, and children in Tennessee. Please share with your friends, family, students, and colleagues and encourage them to attend and show their support as well.

For more information, please contact Tamara Currin via email at tcurrin@marchofdimes.com or by phone at 615-800-7181. We appreciate your support!
*
1. What is your first and last name?
*
2. What organization are you representing?
*
3. What is your job title?
*
4. What is your address? (please include city and zip code)
*
5. What is your email address?
*
6. What is your phone number?
*
7. Will you attend Advocacy Day on Tuesday, March 18th from 8:30am-3pm CST?
*
8. Will you attend the Legislative Reception on Monday, March 17th from 5:30-7:30pm CST?
*
9. Will you attend the Conference Call Training on March 13th from 1-2pm CST/2-3pm EST? (recommended for all Advocacy Day participants)
10. Additional Comments:
Powered by SurveyMonkey
Check out our sample surveys and create your own now!