Computer/Electronic Accommodations Program (CAP)

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Request CAP at Your Event

Please fill out this form to request that CAP attend your event or training. All fields are required.

Event Name/Title:

Sponsoring Agency:

Description:

Start Date:

Start Time:

End Date:

End Time:

Name of Venue:

Address:

City:

State:

Country:

Zip Code:

POC Name:

POC Phone:

POC Cell:

POC Email:

How would you like CAP to participate?

Presentation
Panel
Exhibit
Attend

Will there be other speakers/exhibitors in attendance?

YesNo

If so, please list their names and roles:

Are you willing to cover travel costs for CAP staff?

YesNo

Who will be introducing the speaker?

Who is the official host of the event?

Approximate number of people attending event:

Will the event be open to the general public?

YesNo

Will there be media coverage of this event?

YesNo

If yes, which media organization(s) will be covering this event?

Are you willing to invite employees from surrounding agencies?

YesNo

Are you interested in a specific area of service or initiative within CAP?

What type of audience are you expecting (Rank, Grade Level, Job Type)?

Please provide a description of the audience seating (Classroom, Auditorium, Exhibit Hall, etc.):

Will your senior leadership be in attendance?

YesNo

If so, who?

Has CAP participated in this event in the past?

YesNo

If so, please list the approximate month/year:

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