2022 Washington Seminar Virtual Participation Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Name *

Email Address *

Preferred Telephone Number *

I can participate in the Washington Seminar as follows

Check all times that work for your schedule. If none of the other options work, choose the "other" option and provide information about your availability on the line that follows that choice.

Anytime on Tuesday, February 8

Anytime on Wednesday, February 9

Anytime on Thursday, February 10

Any Morning

Any Afternoon

I can meet with my representative if you will share that meeting time with me.

I can meet with one or both of our senators if you will share those meeting times with me.

Other:

Comments

This question is optional, but if you feel like you need to explain any of your responses, or if you want to share any other information you think would be helpful, use this space to do that.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of National Federation of the Blind of Texas. Report Abuse

Forms