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* 1. Name:

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* 2. Email Address:

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* 3. Phone Number:

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* 4. Employer:

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* 5. Job Title:

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* 6. Are you a PRSA member?

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* 7. Years of Experience:

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

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

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

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* 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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