Attendee Form

1

Attendee Contact Information* This field is required.

Please enter your name

Please enter your email

Please enter your phone

Please enter your address

2

Are you registering for a second attendee?* This field is required.

YESNO

3

Second Attendee Information

Please enter their name

Please enter their email

Please enter their phone

Please enter their address

4

Neighborhood and Quadrant* This field is required.Let us know where you're from

Please enter your neighborhood. (If you don't live in the City of Fort Wayne, please indicate that.)

Pick your quadrant

5

Food Allergies and Accomodations* This field is required.Reasonable accommodations for persons with a known disabling condition will be considered in accordance with state and federal law. Any persons needing a reasonable accommodation should notify Réna at 260-427-2284 or TTY Phone Number (260) 427-1200, within a reasonable time prior to the meeting.

Please list any food allergies

Please list any special accommodations you may need

6

What meals will you be present for?* This field is required.Select all that apply

Breakfast/Welcome 7:30-9:00am

Lunch/Keynote 12:30-2:00pm

Dinner/Neighborhood Awards Ceremony 5:00-7:00pm

None

7

Reason for interest

Interest in starting an association

Wanting to improve an association

General interest in topic

Keynote Speaker

Other

8

Other InformationIs there anything else we should know?