JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Journalist in Residence: Amy Westervelt
Wednesday, April 21, 2021 - 7 to 8 p.m. Central Time
Please complete one form per participant:
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First name
*
Your answer
Last name
*
Your answer
Email address
*
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
What is your relationship to the La Follette School?
Student
Alumni
Faculty or Staff
Friend or Other
Clear selection
Would you like to subscribe to the La Follette School's e-newsletter?
Yes
No
Clear selection
How did you hear about this event? Please check all that apply:
Inside UW-Madison
La Follette School email message
Social media
Milwaukee Journal Sentinel
The Capital Times
Wisconsin State Journal
Isthmus
Madison.com
WisPolitics
The Weekly
Friend/colleague
Other:
This event will include time for audience questions. To help organizers streamline the process and allow for as many questions as possible, please submit your suggestions via this form. Questions received by April 19 will receive priority.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of UW-Madison Google Workspace.
Report Abuse
Forms
