COMMUNITY SERVICES AWARENESS DAY REGISTRATION FORM 2019

If you see this don't fill out this input box.

This form is to participate in the Community Service Awareness Day on Tuesday,  April 9, 2019.

Event will be held in the lower level of the Commodore Cafe' and will be limited to the first 40 respondents. Outside venue will be available as overflow as weather permits. 

The Publicity Flyer DEADLINE is March 26, 2019.
The FINAL DEADLINE is April 2, 2019.

Agency's Name: (Required)

Contact Person: (Required)

Phone Number: (Required)

Email Address: (Required)

Will you be able to participate this year? (Required) Please Select Yes, I would like to participate in Community Services Awareness Day. No, I will not be able to attend Community Services Awareness Day this year.

If ABLE TO PARTICIPATE, please fill out the attendee information and door prize sections.

If NOT ABLE TO PARTICIPATE, please choose your future invitation preference.

First and Last Names of Individuals Attending:

Special Needs:

Please Note: Persons sponsoring booths will not be eligible for door prizes. Thank you for being understanding of this policy.

Will your agency be able to provide a door prize? (Required) Please Select I am able to provide a door prize. I am unable to provide a door prize.

If able to provide a door prize, what will your agency contribute?

If NOT ABLE TO ATTEND, would you like to be invited again? Please Select Please keep me on the permanent invitation list. Please remove me from the permanent invitation list.

 

 

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