VA Power Dialog Registration
Please use this form to register either yourself or your group for the VA Power Dialog in Richmond on April 8, 2016.
What is your name? *
Your answer
I am a: *
Required
If you are currently affiliated with a college/university/school, please list your school name:
Your answer
What is your email address? *
Your answer
Please confirm your email address. *
Your answer
Are you registering yourself, students in a course, or students from a student organization? Check all that apply. *
Required
If applicable, what is/are the name(s) of your course and/or organization? *
Your answer
If applicable, how many students will attend from your course and/or organization? *
Your answer
Please indicate which of the following events in which you and/or your group will participate. Check all that apply. *
Required
If you are part of a course or organization, how are you examining energy, environmental, and/or policy issues in Virginia? *
Required
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