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 *
Event Contact Last Name *
Email Address for Event Information *
Event Contact Phone Number (Please use format nnn-nnn-nnnn)
City or Town where event is being held *
Zip Code where the event is being held *
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) *
State *
Congregation or Organization Presenting Event *
Please enter a BRIEF event description *
Link to Event Registration
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