Georgia EPFP Intake Form

Personal Preferences

Please note that the name you enter here will be used for all correspondence and will appear as typed on your nametag, and table tent, etc.

Preferred Name(Required)

Organization/Institution(Required)

Preferred Email Address(Required)

Preferred Phone Number(Required)

Professional Bio (250 words or fewer)(Required)

Professional Headshot

Please upload a high-resolution headshot

Drop files here or

Accepted file types: jpg, png, Max. file size: 5 MB, Max. files: 1.

Twitter Handle

LinkedIn URL

Preferred Mailing Address(Required)

RSVP

Please use this form as your way of RSVPing for the upcoming events.

Welcome Reception(Required)

Wednesday, August 21st, 5:30 - 7:00 PM Metro Atlanta Chamber

Yes

No

Maybe - will let Kiley Lucier know by EOD August 1st

Plus-One?(Required)

Do you plan to bring a plus-one?

Yes

No

Maybe - will let Kiley Lucier know by EOD August 7th

If yes, what is your plus-one's full name as they would like it to appear on their nametag?

Opening Retreat(Required)

Sunday, September 8th - Monday, September 9th Callaway Resort & Gardens

Yes

No

Maybe - will let Kiley Lucier know by EOD August 1st

Please complete the form below to ensure
you have the best EPFP experience possible