Thank you for your interest in being a cross-promotional partner at Tekko 2019!

Each organization should only complete this survey ONCE. If you believe that you, or another representative from your organization, have previously completed the survey, contact Alexander Miller at alexander.miller@pittjcs.org to confirm. Any questions or concerns can also be sent to Alexander.

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* 1. What is the name of the organization that you represent?

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* 2. Provide a brief description of your organization.

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* 3. Who is your organization's main contact?

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* 4. Which resources are your organization interested in swapping with PittJCS? Please select ALL relevant options.

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* 5. If requesting a badge swap, how many individuals will be representing your organization? If your organization provided PittJCS with more than four badges at your event, please mark "4" and contact Alexander directly.

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* 6. If requesting a badge swap, list the full names (first and last) of all individuals who will be representing your organization.

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* 7. If requesting a hotel swap, which nights does your organization plan to stay in the room?

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* 8. If requesting a hotel swap, whose name should the room be listed under?

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* 9. Who should PittJCS contact to receive our reciprocal swap from your organization?

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* 10. By filling out this form, I understand that my organization must abide by all Tekko 2019 rules and the David L. Lawrence Convention Center's Code of Conduct during our reciprocal swap at Tekko 2019.