NEPCSA Day on the Hill

NEPCSA Massachusetts Day on the Hill
Pearson Learning and Massachusetts State House



Please register by May 31, 2019

School/Company	*	Address* City...*
State	*	....Zip Code* Phone* Fax...

Legislative meetings will be held between 1 pm - 3 pm.

Meeting Options		Please schedule meetings with our senator and representative. I /we will make an appointment with

State Senator		State Representative


Name # 1		Title # 1 Email # 1
Name # 2		Title # 2 Email # 2
Name # 3		Title # 3 Email # 3
Name # 4		Title # 4 Email # 4

There is no charge to attend the NEPCSA Day on the Hill, but your sponsorship would be appreciated.

Sponsors		Platinum - $1,500 Gold - $1000 Silver - $500 Bronze - $250
Other

Total Fees
Payment		Master Card VISA AMEX
First Name		Last Name Email
Account Number		Security # Exp. Mo.Exp. Yr