Register to Share Your Input on the White House's National Action Plan on Gender-Based Violence
This form is to register for the listening session hosted by ASISTA to share your insights and recommendations to the White House as they develop the U.S.'s first National Action Plan on Gender-Based Violence. The listening session will be held on Monday, October 4th at 11 am PST/ 12 pm MST/ 1 pm CST/  2 pm EST on Zoom. This listening session will be recorded.

If you have any questions, please reach out to Ahlam Moussa at ahlam@asistahelp.org or Maria Lazzarino at manager@asistahelp.org.  

Thank you! We hope you will join us.
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When: Monday, October 4, 2021 at 11 am PST/ 12 pm MST/ 1 pm CST/  2 pm EST
First and Last Name *
Email *
Organization *
Job title *
Do you need interpretation? (e.g., Spanish, ASL). Please note that we will do our best to accommodate all requests received by Wednesday, 9/29. *
If yes, please specify your interpretation need:
Do you want to speak at the listening session for 2-3 minutes? If yes, please select your topic and briefly specify below.
Clear selection
Please briefly specify what you'd like to  address:
After your registration is approved, you will receive an email with the Zoom information to join the listening session.  
THANK YOU!
ASISTA advances the dignity, rights and liberty of immigrant survivors of violence.

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