IGA Listserv Form

Name (First and Last)

Email Address

Phone number

Professional Title

Organization Name

Organization Address

City

State

Zip code

Please share any issues/topics of most interest to you regarding the FCC’s work.

Privacy Act Statement

Authority: The Commission is authorized to pursue this collection pursuant to the authority contained in 47 U.S.C. 151, 152, 155, 257, 303; and 5 U.S.C. 602(c) and 609(a)(3).

Purpose: The purpose of this collection is to create a contact list for public events hosted by the Commission’s Consumer and Governmental Affairs Bureau (CGB ).

Routine Uses: The Commission intends to use this information solely for the purpose of building a contact list for invitations to public events hosted by the Commission. A complete list of the routine uses for other types of personally identifiable information collected and maintained by the Commission for the purpose of public outreach is published in the FCC-1, Outreach, system of records notice posted at https://www.fcc.gov/managing-director/privacy-transparency/privacy-act-information.

Disclosure: Providing personally identifiable information to be added to the CGB event contact list is voluntary. However, providing this information will help the Commission invite you to public events.