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AACOG Day at the Capitol Registration Form

  1. AACOG member governments are invited to attend AACOG's Day at the Capitol on Tuesday, March 12, 2013, in Austin. Meals will be provided. Transportation will depart from AACOG promptly at 7:00 a.m. Activities begin at the Capitol at 8:30 a.m. and busses will return to AACOG at approximately 6:30 p.m. Tentative AACOG Day at the Capitol Agenda. Please respond by March 6th to help us ensure that we have adequate transportation for everyone. Please contact Julie Sakelakos at (210) 362-5260 or jsakelakos@aacog.com with any questions.

  2. Please enter your first name.

  3. Please enter your last name.

  4. Will you be attending the AACOG Day at the Capitol?*

  5. Transportation Needed?*

    Please indicate if you will be utilizing the transportation provided by AACOG. The bus will be leaving AACOG at 6:15 a.m.

  6. Please list the AACOG member government you work for.

  7. Please indicate your position at the government entity.

  8. Please provide us with a way to contact you with further information. If no email address is available, please list your work phone number.

  9. Please list your mobile phone number so AACOG is better able to contact you during the event with any necessary information.

  10. Please list first and last names of any other individuals from your entity that you would like to register to attend this event.

  11. Please let us know of any dietary restrictions, if you have questions about the event, or if you would like us to contact you with more information.

  12. Leave This Blank:

  13. This field is not part of the form submission.