2026 Rally for Medical Research Participant Sign-Up General Information Registration Deadline: September 9, 2026 Website Question Title * 1. Please enter your full name First Name Last Name Suffix (MD, PhD, Jr., Sr., etc.) Question Title * 2. Business Name / Organization (if applicable) Title/Role (if applicable) Affiliated Organization Question Title * 3. Please provide your home address. Address * Address 2 City/Town * State/Province * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code * Country Question Title * 4. Please provide a contact number in order to reach you while in Washington, DC with any day-of-the-Rally changes. Question Title * 5. Email Address Question Title * 6. Please include your business address if it's in a different congressional district than your home. Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Phone Number Question Title * 7. Have you participated in a Hill Day before? Yes No Question Title * 8. What events will you participate in during the 2026 Rally for Medical Research? Rally for Medical Research Training (3:00 pm - 5:00 pm Wednesday, September 16) Embassy Suites by Hilton Washington DC Convention Center, Washington DC Reception to Celebrate Medical Research (6:00 pm - 8:00 pm Wednesday, September 16) Capitol Hill, Washngton, DC Rally for Medical Research Breakfast (7:00 am - 9:00 am Thursday, September 17) Embassy Suites by Hilton Washington DC Convention Center, Washington DC *Please note that attendance at both the Rally for Medical Research Training and Breakfast is highly recommended, especially for first-time Rally participants. Question Title * 9. Are you interested in hotel accommodations in Washington DC for the Rally for Medical Research? Yes No Question Title * 10. Do you have any special relationships with House or Senate offices? If yes, list office(s). Question Title * 11. How would you describe yourself? Government affairs professional Affiliated organization staff Patient advocate Scientist Student Physician or healthcare professional Industry representative Survivor Other (please specify) Question Title * 12. Would you be interested in serving as a state leader for the 2026 Rally for Medical Research Hill Day? Yes No Other Question Title * 13. Do you require any special accommodations to participate in the Rally for Medical Research? Please include any dietary restrictions. No Yes (please specify) To ensure a coordinated and effective Hill Day, all congressional meetings will be scheduled through Soapbox Consulting, which manages logistics on behalf of the Rally for Medical Research coalition. Done