Fall Meeting Registration Form

Delegate Name - include any titles*

If you are not the Council President, please put the name of your President:

Contact Info

Phone*

Email address*

Parish Council

Parish Council Name*

Town/City*

Special needs

Comments or questions:

Emergency Contact

Please provide the name of the person we should contact in case of emergency and the best way to reach them at the time of the meeting.

Name of Emergency Contact*

Relationship:*

Phone:*

Email Confirmation

This registration does not guarantee your space - your confirmation will be emailed separately.

Please check that the email address you give below is correct and is the one you want us to use:

to email you a copy of your registration.
to email confirmation upon receipt of payment
for future communication about the meeting

Then click the Submit button to send this form. Your registration will be emailed to you.

Please email confirmation to me at*

IMPORTANT!

You should see a thank you note when you click the "submit" button. If you don’t see it, your form did not go through. Scroll back up to review the form and ensure all required fields are completed; then click “submit” again.

When it is successfully submitted, you will be sent an automated email with the details of your submission, payment instructions, etc. If you do not receive the email within 5 minutes, please contact our webmaster.

If you have questions about the meeting, contact our Registration Chair.

If you have problems with or comments about the form itself, email our webmaster. It may be helpful to include a phone number she can call to discuss it with you.

Thanks for registering. Please check your emails for a copy of your submission.