IOA's Advocacy Day at the State House RSVP
January 11, 2022 -10:30 a.m. to  3:00 p.m. ET
3rd Floor, Indiana State House, 200 W. Washington Street, Indianapolis, IN

Please complete this form to RSVP for IOA's Advocacy Day at the State House.  This information will allow us to determine turnout, inform legislators who will be coming to the event, and plan for food and beverages.  Your email address is requested in case last minute changes are required - it will not be shared with third parties.  Thanks!!
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First and Last Name: *
Email Address: *
Name of city or town where home is located: *
Name of city or town where practice is located: *
If you have a personal relationship with a legislator(s), please provide their name(s) so that we can let them know you will be attending the event.
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