Neighborhood Networks Week
Registration Form
August 4–9, 2008
Indicates this field is required.
Property Name
Center Name:
First Name:
MI:
Last Name:
Title:
Street:
City:
State:
-
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Phone:
Fax:
Email:
Please answer the following questions:
1. Type of housing served (check all that apply)
Senior
Family
Assisted
Market rate
Section 8
Section 236
Public housing
2. Event information
Name of Event:
Date:
-
08/04/2008
08/05/2008
08/06/2008
08/07/2008
08/08/2008
08/09/2008
Start Time:
End Time:
-
AM
PM
Description of Event (activities planned, special guests, etc.):
Anticipated Attendance:
For more information about Neighborhood Networks Week national events, please call the Neighborhood Networks Information Center toll-free at (888) 312–2743. The hearing impaired may access Neighborhood Networks via TTY by calling the Federal Information Relay Service at (800) 877–8339.