Survey - 2012 Membership Meeting - The Equal Rights Center

2012 Membership Meeting

Please fill out the form below to help us make the 2012 ERC Members Meeting a success for all of our members.
If you have any questions about the meeting please email the ERC at members@equalrightscenter.org or call 202-30-3204.
We look forward to connecting with you on the 29th!

1.

Please fill out the form below.

*

Name:

First Required	Last Required

*

Email: Required

Street 1:

Street 2:

City/State/ZIP:

City	State	ZIP

Phone Number:

Employer:

Yes, I would like to receive e-mail from The Equal Rights Center

Yes, I would like to receive postal mail from The Equal Rights Center

*2.

Question - Required - How will you be attending the meeting? Via teleconference
In person at the ERC's office

3.

Question - Not Required - Please state if you require a reasonable accommdation under the Americans with Disabilities Act (ADA), and what that is. The ERC's office is located in an accessible building; if you require any other reasonable accommodation, state below. Please make all requests for reasonable accommodations by March 15, 2012.

2012 Membership Meeting

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Equal Rights Center