Government Employee Registration

• • First Name*
  • Last Name*
  • Email*
  • Department*
  • Title*
  • Address*
  • City*
  • State*
  • Zip Code*
  • Phone*
  • Do you plan to attend the Wednesday, March 9, 2022 Youth/Emerging Leaders Summit?
    • Yes
    • No
  • Do you plan to attend the Thursday, March 10, 2022 general session?
    • Yes
    • No
  • Do you plan to attend the opening reception on Thursday evening, March 10, 2022?
    • Yes
    • No
  • Do you plan to attend the Friday, March 11, 2022 general session?
    • Yes
    • No
  • How did you hear about the National Environmental Justice Conference and Training Program?
  • Did you participate in the 2020 National Environmental Justice Conference and Training Program virtual conference?
    • Yes
    • No
  • Did you participate in the 2021 Joint National Environmental Justice Conference and Training Program and 13th National Conference on Health Disparities virtual conference?
    • Yes
    • No
  • What is your primary job, role or interest in environmental justice?
  • What is your primary job, role or interest in environmental justice?
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