Assisted Living/OKALA Day at Capitol 2019 - RSVP

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* 1. Thank you for your RSVP to our 2019 OKALA Day at the State Capitol! Please enter your information including your personal address. This is so our lobbyist, Patrick Gaines, can try to schedule a time to meet with your State Senator and/or Representative.

Name

Phone Number to contact day of event

Email address for event information & reminders

Personal Street Address

City, State, Zip

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* 2. Please check all that apply

I am an OKALA Provider Member (Assisted Living Community)

I am an OKALA Industry Provider Member

I am not an OKALA Member, but would like to participate

I am interested in having a booth at the event

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* 3. If you are an OKALA Member, please enter your Company/Community's name and address. (if not, enter n/a on lines)

Company/Community Name

Mailing Address

City, State, Zip

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* 4. If you are from an Assisted Living, will you be bringing any residents?

Yes

No

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* 5. If you are bringing Residents, please let us know approximatley how many so that we can arrange the proper meeting space to meet with their representatives.

Thank You for registering for the 2019 Assisted Living/OKALA Day at the Capitol!