* 1. Name:

* 2. Email Address:

* 3. Phone Number:

* 4. Employer:

* 5. Job Title:

* 6. Are you a PRSA member?

* 7. Years of Experience:

* 8. Are you an accredited member (APR)?

* 9. Please select when you are available for team meetings:

* 10. What types of nonprofits are you interested in supporting?

* 11. By participating in PR 360, I understand that the program will begin May 1 and conclude on June 18 at the PR 360 presentation. I agree to attend team meetings, contribute to the campaign and present at the PRSA meeting on June 18.

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