NPCA Capitol Hill Day of Action February 28, 2019 Registration Form
During NPCA's National Days of Action in Support of the Peace Corps please join us in Washington, DC for our Capitol Hill Day of Action on Thursday, February 28, 2019. With high supply and demand for volunteers, communities all over the world in need, people-to-people relationships increasingly critical, and the need to pass legislation to help make the Peace Corps the best it can be, join us to tell America's lawmakers to prioritize Peace Corps funding and legislation. Sign up now!

More information and logistics will be sent in the coming weeks to the email address you provide below. Our Capitol Hill advocacy day starts early in the morning and lasts all day, with an end-of-day celebration. Please plan your trip to the nation's capital accordingly.

Urgent questions or concerns? Email Jonathan Pearson at jonathan@peacecorpsconnect.org with the subject "Capitol Hill Day of Action."

First Name: *
Your answer
Last Name: *
Your answer
Cell Phone: *
Please list the phone number—with area code—you will have on hand on February 28
Your answer
Registered Voting Address
Please provide the address where you are registered to vote
Street: *
Your answer
City: *
Your answer
State Code: *
ex: VA, CA, NY
Your answer
Zip Code *
Your answer
Secondary Address (if applicable)
In order to best demonstrate the impact of the Peace Corps community to Members of Congress, we may place you in a group based on a previous address. For example, though you now live in San Jose, you spent most of your professional life in Los Angeles where you made great contributions to your community. Please list any address that you had for several years prior to your current address.
Your answer
My second address is:
(please select one)
If you answered "other" to the previous question, please explain.
Your answer
Please check the following that best describes you:
(you may choose more than one)
If you chose other, please explain.
Your answer
Peace Corps country and years of service:
Include up to 3 tours, using the following format: Kenya 1989-1991; Colombia 1994-1996
Your answer
Are you a current or former member of the Armed Forces? *
Please indicate which of the following best describes your physical capabilities *
If you answered "other" to the previous question, please explain
Your answer
Would you be willing to be considered as a Group Leader? Group Leaders are required to attend the virtual briefing, arrive early to greet your group, lead meetings, carry folders for each office visit, and have a fun day! Group Leaders must attend the entire day.
Will you plan to join us for a celebratory event at the end of our day on Capitol Hill (Approximately 5:30 PM - 7:30 PM)? *
Email (so we can send you information and updates) *
Your answer
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