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* 1. What is your name?

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* 2. What is your affiliation, if any?

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* 3. What is your email address?

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* 4. Will you attend our PROFILES IN LEADERSHIP Release Event to be held at the Massachusetts State House on Tuesday, September 29th, at 1:15 pm?
This event honors women of color elected to office in Massachusetts and is cosponsored by the Women's Pipeline for Change.

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* 5. Do you require special accommodations to attend this event?

If so, please visit the following website to submit your accommodation request:
http://www.umb.edu/odi/ada/accommodations/odi_request_for_special_accommodation

Parking is extremely limited near the State House.
Public transportation is strongly recommended.
Directions to the State House:
https://malegislature.gov/Engage/Directions
We look forward to having you join us on September 29th.
If you have any questions, please feel free to contact us at 617.287.5541.

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