Virtual Town Hall Meeting RSVP Form

Meeting Date: April 30, 2021
Meeting Time: 1:00PM-4:00PM EST
Topic: Promoting self-discipline and preventing further spread of infection

Are you going to attend the Virtual Town Hall Meeting?

YesNo

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Company Name

Position/Title

Have you attended this Virtual Town Hall meeting before?

YesNo

Please select the following tools that you already have for the Virtual Town Hall meeting:

Do you need help or support in using video conferencing apps like Zoom, Skype, or Google Meet?

YesNo

Are you going to attend with another attendee?

Do you have any questions or concerns?

Do you have any suggestions, comments, or special instructions?