Town Hall Attendance Check Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Company Name
Will you be able to attend the town hall meeting?
Yes
No
If no, what is the reason why you won't be able to attend?
Are you going to be late?
Yes
No
For how long (in minutes)?
Do you have any concerns or special instructions to us?
I confirm that I will be able to attend the Town Hall meeting.
I confirm that the discussion will be strictly confidential.
I understand that the meeting needs my full attention and my opinions about the discussion.
I will follow and exercise the standard etiquette during the meeting.
I will respect the opinion of the others and prevent debate if unecessary.
Signature
Date Signed
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: