| Conference Information (Fields marked with * are required) |
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Please enter below all the districts that you represent or enter your organization(s) in the field below.
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| District(s)/Organization(s) |
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| * First Name on Badge |
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* Last Name |
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| Nick Name on Badge |
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| * Title |
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Please let us know if you are the: |
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| * Address |
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* City |
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| State |
California |
* Zip |
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| * Phone |
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District Contact Person |
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| * Email |
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| 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. |
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JPIA Conference Packet and Name Badge |
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RSVP - pre-Board Meeting Lunch |
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