FL-iCAN! Affiliate Event
Please help us promote your FL-iCAN! aligned event. The questionnaire will help us reach the people in our network who are appropriate for your event, and will enable us to track the legislative districts we have reached. If you have questions about this form, please contact David Johnson at dj.jj@att.net
Event Contact Title *
Event Contact First Name *
Your answer
Event Contact Last Name *
Your answer
Email Address for Event Information *
Your answer
Event Contact Phone Number (Please use format nnn-nnn-nnnn)
Your answer
City or Town where event is being held *
Your answer
Zip Code where the event is being held *
Your answer
Zip Last 4 where the event is being held (If you don't know the last 4 digits of the zip code, click through to this site to find it https://tools.usps.com/go/zip-code-lookup.htm) *
Your answer
State *
Your answer
Congregation or Organization Presenting Event *
Your answer
Please enter a BRIEF event description *
Your answer
Link to Event Registration
Your answer
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