REI individual registration

YOUR MAILING ADDRESS *

YOUR PHONE NUMBER *

AREA CODE PHONE NUMBER
DIETARY RESTRICTIONS

Gluten free Vegetarian Vegan Nut allergy
YOUR RACE (FOR REI RECORDS) *

African American or black American Indian or Alaska native Asian Caucasian or white Hispanic or Latino(a) Native Hawaiian or other Pacific Islander
YOUR AGE (FOR REI RECORDS) *

15-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 91-100
YOUR GENDER (FOR REI RECORDS) *

Female Male Other
YOUR INDUSTRY (FOR REI RECORDS) *

Business or corporation Education Faith-based organization Government Nonprofit Neighborhood resident Social justice organizer or advocate Retired
YOUR SPONSORING ORGANIZATION (SEE NOTE AT TOP OF PAGE)

Ashley Hall Charleston County School District Charleston Kids Coalition Charleston Promise Neighborhood Coastal Community Foundation Meeting Street Schools Metanoia North Charleston Police Department Reading Partners (staff & board) Serenity Now Sophia Institute Teach for America Tri-County Cradle to Career Trident United Way Repeating REI participant
COMMENTS (IF ANY)
YOUR DESIRED WORKSHOP *
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Feb 2019 Phase II
April 2019 Phase I
May 2019 Phase I
June 2019 Phase I
July 2019 Phase I
August 2019 Phase I
Sept 2019 Phase I
Oct 2019 Phase I
Nov 2019 Phase I
ARE YOU A YWCA.GC MEMBER?
Our members receive 10% off all our events! If you are a YWCA.GC member, please enter coupon code YWCA.GC
10% OFF
100% OFF
TOTAL COST

TOTAL COST

USD Description