NPCA Capitol Hill Day of Action                  Thursday, March 5, 2020                                     Registration Form
During NPCA's National Days of Action in Support of the Peace Corps please join us in Washington, DC for our Capitol Hill Day of Action on Thursday, March 5, 2020. With 2019 legislation that threatened the future of Peace Corps, join us to tell Congress to protect and defend Peace Corps. Sign up now! REGISTRATION WILL CLOSE ON MONDAY, FEBRUARY 10, 2020.

More information and logistics will be sent in the coming weeks to the email address you provide below. Our Capitol Hill advocacy day starts early in the morning and lasts all day, with an end-of-day celebration. Please plan your trip to the nation's capital accordingly.

Urgent questions or concerns? Email Jonathan Pearson at jonathan@peacecorpsconnect.org with the subject "Capitol Hill Day of Action."
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First Name: *
Last Name: *
Cell Phone: *
Please list the phone number—with area code—you will have on hand on March 5.
Registered Voting Address
Please provide the address where you are registered to vote
Street: *
City: *
State Code: *
ex: VA, CA, NY
Zip Code *
Secondary Address (if applicable)
In order to best demonstrate the impact of the Peace Corps community to Members of Congress, we may place you in a group based on a previous address. For example, though you now live in San Jose, you spent most of your professional life in Los Angeles where you made great contributions to your community. Please list any address that you had for several years prior to your current address.
My second address is:
(please select one)
If you answered "other" to the previous question, please explain.
Please check the following that best describes you: *
(you may choose more than one)
Required
If you chose other, please explain.
Peace Corps country and years of service:
Include up to 3 tours, using the following format: Kenya 1989-1991; Colombia 1994-1996
Please indicate which of the following best describes your physical capabilities *
If you answered "other" to the previous question, please explain
Would you be willing to be considered as a Group Leader? Group Leaders are required to attend the virtual briefing, arrive early to greet your group, lead meetings, carry folders for each office visit, and have a fun day! Group Leaders must attend the entire day.
Clear selection
Will you plan to join us for a celebratory event at the end of our day on Capitol Hill (Approximately 5:30 PM - 7:30 PM)? *
Email (so we can send you information and updates) *
Submit
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