MEETING REQUEST FORM

Request the JPIA Conference Packet, Name Badge, and RSVP for the pre-Board Meeting Lunch
Deadline Date to Request: Deadline – April 11, 2019
2019 Spring Conference

    Conference Information (Fields marked with * are required)


    Please enter below all the districts that you represent or enter your organization(s) in the field below.

    District(s)/Organization(s)

    * First Name on Badge

    * Last Name

    Nick Name on Badge

    * Title

    *
    Please let us know if you are the:

    JPIA DirectorJPIA Alternate DirectorOther

    * Address

    * City

    State

    California

    * Zip

    * Phone

    District Contact Person

    * Email

    Name Badge Only

    (I will download my own JPIA Conference Packet)

    Please check the following box if you would like to have the JPIA Conference Packet and name badge sent to you.

    JPIA Conference Packet and Name Badge

    RSVP - pre-Board Meeting Lunch