Grassroots Summit RSVP Form - Community Action Works

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Community Group/ Organization

Role with Community Group / Organization

Are you currently working with a community group? If so, what issue are you working to address?(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What trainings are you most excited about?

Any other issues panels, trainings you would like to see at the summit?

Do you have any dietary restrictions or food alergies?(Required)

How did you hear about this event?

Would you or your organization like to become a sponsor?

Become a sponsor where you or your organization can help spread the word about the summit, add your logo and help fund travel grants so we can reach more communities with our training.

(If yes to becoming a sponsor) Please upload your organization’s logo

Max. file size: 2 GB.