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Request the JPIA Conference Packet, Name Badge, and RSVP for the pre-Board Meeting Lunch
Deadline Date to Request: November 2, 2017
2017 Fall Conference
Conference Information (Fields marked with * are required)
List of Districts Chosen District(s)
* District(s)

Please select from the list above all the districts that you represent or enter your organization(s) on the field below.
Organization(s)
* First Name on Badge * Last Name
Nick Name on Badge    
* Title * Please let us know if you are the:

* Address * City
State California * Zip
* Phone District Contact Person
* Email
Name Badge Only  
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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