Registration for PPW 2018 Bootcamp Session 3: Leading the Charge

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* 1. Please provide your contact information.

First Name:

Last Name

State:

Email Address:

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* 2. Attendance at the PPW 2018 Bootcamp Session 3: Leading the Charge on Tuesday, October 23 from 10am to Noon is expected for all PPCs, PALs and/or Alternates. Will you be attending the event?

Yes

No

Other affiliate representative will attend

Comment (please specify)

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* 3. What is your role on the Public Policy Panel?

Affiliate President

Affiliate President-elect

PPC (affiliate)

DPG PAL

Alternate

SPR

SRS

CPC

RR

Affiliate Delegate

Other (please specify)

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* 4. Do you have any other comments, questions, or concerns?