Connection in Action Campaign Sign-Up

Count Me In: Capital Region Connection in Action

1. What's your name? *This question is required.

2. What's your email address? *This question is required.

3. What action(s) are you planning to take to connect with your neighbours or community?
This can take any form, big or small, from greeting a neighbour to organizing an event *This question is required.

4. Are you planning to host or organize an event or activity that you'd like listed in our public calendar? *This question is required.

5. Please provide details about your event:
Please include:

Event title
Short description (1–3 sentences)
Organizer(s)
Date and time
Location or address
Accessibility information, if available
Registration or info link, or contact details for interested participants

*This question is required.

5. Would you like to receive campaign updates, including tips and resources, in the lead-up to and during Loneliness Awareness Week? *This question is required.