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Organization *

Event Date (You must have a firm date selected for us to schedule a speaker) *

Event Start Time (Please let us know when your event is scheduled to begin (e.g., 6 pm) *

Event location (Designate Zoom if virtual) *

What county will the event be located in? *

How many attendees do you expect? * Under 25 26-100 101-250 Over 250

For Virtual Presentations, does your organization have a Zoom Account? * Yes No Not applicable

For In-Person Events, does your organization have access to a projector for Power Point Presentations? * Yes No Not Applicable

Is this event open to the public? * Yes No

Preferred format/length of Fair Districts PA program * 15-30 minute talk (includes little or no time for questions) 30-60 minute talk (includes time for questions) Small Group Option Panel Discussion

What topic(s) would you like us to cover? * Current Process and Problems with Redistricting in Pennsylvania Redistricting Reforms and Legislation How Redistricting and Reforms Impact Minority Communities Redistricting Reform Update #FixHarrisburg and Reforming the Rules Prison Gerrymandering How individuals and organizations can advocate for change

We also have a Spanish presentation available that covers gerrymandering and unfair procedural rules I'd like the Spanish presentation

Proposed Event Name (Optional)

Anything else we should know? If your group has heard our basic presentation, please let us know that this presentation will be an update.

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