White House Initiative on Asian Americans and Pacific Islanders Texas Regional Conference

First Name:

Last Name:

Telephone :

Email Address:

Street Address:

City:

State:

Zip Code:

Organization/Affiliation:

What issue most concerns you? :

The Conference may be able to provide language interpreters. If you need a language interpreter, what language? :

The Conference may be able to provide transportation (bus or van) if you live within 3 hours of Houston and lack easy means of getting to the Conference. If you need transportation assistance, which city will you be traveling from? :

Austin

Houston

San Antonio

(Note: After you register, you will be contacted by a local organizer, who will tell you: whether the Conference will provide you with transportation; when and where to get on the vehicle; and who to contact if you have any questions.)

Do you have any dietary restrictions?:

What do you want to get out of the Conference?:

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