2023 Samuel J. Heyman Service to America Medals® Finalist Reception You are invited to a reception honoring the finalists of the Samuel J. Heyman Service to America Medals®. Kindly RSVP by completing the form below. Date Thursday, May 11, 2023 Time 4:30 p.m. – Doors Open5:00 p.m. to 7:30 p.m. – Panel and Reception Location Partnership for Public Service600 14th Street, NWSuite 600Washington, DC 20005 Dress Code Business dress Additional Information Learn more about the Sammies at www.servicetoamericamedals.org For questions about this event, contact us at [email protected] or (202) 775-6883. NOTICE: You will be required to upload a file copy of your COVID-19 vaccination card or proof of exemption to complete your RSVP form. Please make sure you have your copy handy before you start the RSVP process. RSVP Form First Name Last Name Email Company/Agency/Affiliation What is your industry?Federal GovernmentCorporate or Private SectorNonprofit or Advocacy Group MediaAcademiaRetiredOther Will you be attending the event?Yes, I will attend in-personNo, I regretfully decline Are you a guest of a 2023 Sammies finalist?YesNo Which finalist are you are a guest of ? Do you need to request a reasonable accommodation? YesNoTo provide the best service, we ask that requests be made at least 72 hours in advance. Accessibility How would you prefer to be contacted?Phone CallEmail What is your phone number? Please briefly describe how you would like us to accomodate you. Please DO NOT disclose private medical information, but please DO include any details that you think would help us best help you. For a list of common accomodations, please see our accessibility page. We will reach out shortly. If you have any questions, please contact Maggie Moore by email at [email protected] or call (202) 775-6883. Health & Safety Info The Partnership for Public Service is committed to the health and safety of our guests. We will adhere to all District of Columbia and federal protocols related to COVID-19.Attendees are required to provide proof of vaccination against COVID-19 or a negative COVID-19 test taken within 72 hours of the program. Masking is optional. Are you fully vaccinated? YesNoFor the purposes of right of entry to the Partnership, a person is considered fully vaccinated: 2 weeks after their second dose in a 2-dose series, such as the Pfizer and Moderna vaccines, or 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s vaccine. What type of vaccine did you receive?Please select... Johnson & Johnson Moderna Pfizer Other If Other, please list your vaccine type. When did you get your first vaccination shot? When did you get your second vaccination shot? For proof of vaccination status, please upload a copy of your CDC-approved COVID-19 vaccination record card. Thank you for your interest in joining us for this program. Please note, the Partnership has adopted a “Vaccination or Negative Test Required” approach for all attendees.Individuals who are not vaccinated will need to bring a negative COVID-19 test to the program. Only negative tests taken within 72 hours of the program will be accepted. Our strong preference is that you email the test results ahead of your arrival, otherwise your negative test will be checked at the door. By checking the box below you confirm your plans to bring proof of negative status to the program. Please check the box if you would like to receive program updates and other Partnership for Public Service news. I would like to receive program updates from the Partnership for Public Service. Contact Information
