2025 Partners in Policymaking Reunion

The 2025 PIP Reunion will be held on August 29th & 30th, 2025 at the Baton Rouge Marriott.

Due to limited spots we will be reviewing all submissions to ensure that we will have equal representation throughout our state, alumni years, and all Demographics. Deadline for submission is Friday, July 11th 2025. If chosen you will be notified by email the week of July 21st.

2025 Partners in Policymaking Reunion Interest Form

Are you available on August 29-30, 2025 to attend?*
- Yes
- No
PIP Application
Name*
First Last
Address*
Street Address Address Line 2 City ZIP Code
Primary Phone Number*
Secondary Phone Number
Email*
Enter Email Confirm Email
PIP Graduation Year
Louisiana Region*
Are you a PERSON with a developmental disability?*
- Yes
- No
If you answered YES, please answer the following
Current Age Disability/Diagnosis Your age at onset of disability
Are you a PARENT of a CHILD with a developmental disability?*
- Yes
- No
COMPLETE ONLY FOR YOUR CHILD WITH A DEVELOPMENTAL DISABILITY:
If there is more than one child with a developmental disability, please click the plus (+) beside the question to add each additional child
Child's information
Child's Name Current Age Disability/Diagnosis Age at onset of disability
7.. Are you or your son/daughter receiving or waiting for services by the Regional Human Services District or Authority, Office for Citizens with Developmental Disabilities, or Office of Behavioral Health?*
- Yes
- No
a. If Yes, check all that apply to you or your child (receiving the service or on a waiting list to receive the service)
- New Opportunities Waiver (NOW)
- Children’s Choice (CC)
- Supports Waiver (SW)
- Residential Options Waiver (ROW)
- Individual / Family Support
- Flexible Family Fund
- EarlySteps
- I am not receiving nor on the waiting list for a service
If traveling more than 50 miles from home to attend the reunion, would you like a guest room on Friday, August 29th?*
- Yes
- No
- Possibly
a. If Yes, do you need an accessible room?
- Yes
- No
b. Are you open to having a roommate?
- Yes
- No
c. If you're open to a roommate, who would it be?
Who is your Current State Rep & Senator*
Are you a LaCAN member?*
- Yes
- No
Since graduation, how have you used advocacy to help others or speak up for the disability community?*
What advocacy work or roles are you involved in right now?"*
If anyone helped you prepare this application, please provide his or her name, address and phone numbers:
Name Address City State Zip Home Phone Cell Phone
Electronic Signature
By entering your name and date below, you signify that the above information is true and correct to the best of your knowledge.
Name/Signature*
Signature Date*
Name
This field is for validation purposes and should be left unchanged.

Current Age	Disability/Diagnosis	Your age at onset of disability

Child's Name	Current Age	Disability/Diagnosis	Age at onset of disability

Name	Address	City	State	Zip	Home Phone	Cell Phone

The 2025 PIP Reunion will be held on August 29th & 30th, 2025 at the Baton Rouge Marriott.

Due to limited spots we will be reviewing all submissions to ensure that we will have equal representation throughout our state, alumni years, and all Demographics. Deadline for submission is Friday, July 11th 2025. If chosen you will be notified by email the week of July 21st.

2025 Partners in Policymaking Reunion Interest Form

PIP Application

COMPLETE ONLY FOR YOUR CHILD WITH A DEVELOPMENTAL DISABILITY:

Electronic Signature