I&E Days 2025 Registration I&E Days 2025 Registration Form "*" indicates required fields Name * Required First Last Please provide your pronouns.Note: pronouns will be printed on your name badge.Voting Address * RequiredUsed to match you with your state Assembly Member and Senator. In most cases, this will be your home address. Please do not list your office address. Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email * Required Cell Phone:By entering your cell phone number, you agree to receive I&E Days updates and reminders about the event and legislative meetings.What is your Tobacco Control Project or Affiliation? * Required CTPP-funded Project Coalition Member Contractor or Consultant Voluntary Health Organization Please spell out Organization Name: * RequiredNo Acronyms Please Do you have specific concerns about meeting with your legislator for personal reasons? If so, a staff member will be in touch to discuss this further. * Required Yes No Do you have a professional relationship with a current Assembly Member, Senator, or their staff? If so, please indicate who and the nature of the relationship.Each legislative meeting requires a Meeting Lead. I am willing to serve as the Meeting Lead for my Legislative Meetings if asked. * Required Yes Only if Necessary Do you require accommodation (e.g. visual or hearing impairment, accessibility needs, language interpretation, etc.). If yes, please provide details and a staff member will be in touch to discuss further.The Capitol and Legislative Office Building is about a 15-minute walk from the Holiday Inn. Do you require transportation to and from the Capitol Grounds from the Holiday Inn? If yes, please provide details, and a staff member will be in touch to discuss further.During the event, food will be provided for attendees. Please select dietary preferences: * Required(Note: We value the health of our guests. As advocates for wholesome living, we are committed to offering healthy food and beverage choices consistent with the AHA Dietary Guidelines, including fruits, vegetables, whole grains, and the exclusion of sugary beverages and saturated fats.) Gluten Free Vegan Vegetarian No dietary restrictions Other If you selected "Other", please explain below.Would you like to be added to the Center’s email list? * Required Yes No Hotel Information Holiday Inn Sacramento Downtown – Arena 300 J Street, Sacramento, CA 95814 Hotel Website Check-in: May 27 Checkout: May 28 The opening session and morning gathering session will be held in the hotel’s meeting space. The hotel is a 15-minute drive from Sacramento International Airport (SMF) and 15 min walk from the California State Capitol. Price: $145 (state rate) a night when you use the room block. We strongly encourage those staying overnight to book within the room block. There are limited rooms, we encourage you to book early if you would like to stay at the Holiday Inn. We will be sending the room block link after you register. Consent and AcknowledgementsConsent * Required By registering, I agree to attend the I&E Days Virtual Trainings in advance of the event, or watch recorded trainings if live event does not accomodate my schedule. * RequiredConsent * Required By registering, I agree to attend legislative meetings with my Assemblymember and my Senator and understand that I am expected to prepare with my constituent group in advance of I & E Days. * RequiredThere is a $150 registration fee to attend this event. You will receive an invoice upon completing registration. By checking "Yes," I consent to the terms and conditions of the Talent, Publicity, and Media Consent and Release Form. * Requiredhttps://organizingtoendtobacco.org/wp-content/uploads/2025/01/Consent-Form.pdf Yes No CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on LinkedIn (Opens in new window)
