Registration Michigan PTA Advocacy Seminar March 20, 2021

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* 1. Full Name of person participating

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* 2. Name of PTA Unit and City you are connected with for 2020-21. List NA if not connected to a PTA Local Unit this year.

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* 3. To identify your legislative District we need your home mailing address. This information will not be shared or distributed with any outside parties and will be kept confidential and private.

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 4. There will be legislative calls with local State Representatives and State Senators on March 24, 2021. Do you wish to participate on those video chat conference calls?

Yes

No

Maybe depends on time of day and my schedule closer to the date

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* 5. Select Time of Day you are available for live video conference call on Wednesday, March 24, 2021. Please select all that you are open on that day.

Morning 8:00am to 11:30am

Lunch 11:30am to 1:30pm

Afternoon 1:30pm to 4:30pm

Evening 6:00pm to 8:00pm

Other time or comment (please specify)

None of the above

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* 6. We are looking for volunteers to organize their political district for the video conference call on Wednesday, March 24, 2021. Please let us know if you would be interested in volunteering. Training will be provided. A computer with internet access is required.

Yes would like to volunteer

No

Maybe, please contact me directly