NPCA Capitol Hill Day of Advocacy                  Thursday, March 9, 2023                                     Registration Form
During NPCA's National Days of Advocacy, please join us in Washington, DC for our Capitol Hill Day of Advocacy on Thursday, March 9, 2023. This will be our first return to Capitol Hill in three years. As we are preparing for more complex logistics related to health, security and financial concerns, we ask for your help in the following ways:
  • Please respect our registration deadline to give us sufficient time to plan for your visit: REGISTRATION WILL CLOSE ON MONDAY, FEBRUARY 20, 2023.
  • Please register as soon as you have high certainty you can be with us on March 9th.  Our Hill Day planning software company charges us a fee for each registrant, including those who drop out at the last minute. And, registrants who end up not attending (or seeking to register at the last minute) can seriously impact our meeting scheduling.
More information on venues, exact times, 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.

Questions or concerns? Email Jonathan Pearson at jonathan@peacecorpsconnect.org with the subject "Capitol Hill Day of Advocacy."  Thank you!
Sign in to Google to save your progress. Learn more
First Name: *
Last Name: *
Cell Phone: *
Please list the phone number—with area code—you will have on hand on March 9.
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 pre-event virtual briefings, 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 (location TBD) 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
Clear form
Never submit passwords through Google Forms.
This form was created inside of National Peace Corps Association. Report Abuse
Google Forms