Virtual City Hall Meeting Registration Form

Virtual City Hall Meeting Registration Form
Town Hall Meeting Schedule
Date: April 30, 2021
Time: 1:00PM-4:00PM EST
Topic: Promoting self-discipline and preventing further spread of infection
Requirements:
- Desktop, laptop, tablet, or phone
- Google Hangout/Zoom
- Web camera
- Headset and Microphone
- Internet Connection
Once you sign up, we'll send you an email with the instructions or invite you to Google Calendar.
Name
First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Age
Gender
MaleFemale
You can upload documents here like reports, case studies, images, or videos.
Cancelof
Is there a topic that you want to discuss during the town hall meeting?
Do you have any concerns or reactions that you want to share during the town hall meeting?
Do you have any questions, suggestions, or comments?
Would you like to be part of our Facebook group?
YesNo
Would you like to receive emails coming from us?
YesNo
Countdown until the event
Should be Empty: