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Washington Seminar Registration
Contact 1
Name
Name
Phone Number
Phone Number
Email
Email
Who is your current federal Congressional representative?
Who is your current federal Congressional representative?
Are you a current dues paying member of a local chapter of the National Federation of the Blind of Iowa?
Yes
No
If so, which chapter?
If so, which chapter?
Have you previously attended Washington Seminar?
Yes
No
Why do you want to attend the 2027 Washington Seminar?
Why do you want to attend the 2027 Washington Seminar?
Why do you believe you will be a good fit to represent the National Federation of the Blind of Iowa at this year’s Washington Seminar?
Why do you believe you will be a good fit to represent the National Federation of the Blind of Iowa at this year’s Washington Seminar?
How much financial assistance are you requesting to be able to participate in this year’s Washington Seminar?
How much financial assistance are you requesting to be able to participate in this year’s Washington Seminar?
If you are requesting assistance to pay for airfare, what airport will you be traveling from and what is the current cost of a ticket to Ronald Reagan international Airport for January 31-February 3?
If you are requesting assistance to pay for airfare, what airport will you be traveling from and what is the current cost of a ticket to Ronald Reagan international Airport for January 31-February 3?
If you are requesting assistance with lodging, would you be willing to share a room with another attendee?
Yes
No
Please add anything else you would like us to know.
Please add anything else you would like us to know.
If I am accepted, I will submit my receipts (hotel, airfare, etc), totaling at least the amount the affiliate has awarded, within thirty days of the end of the trip.
Submit
