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Heads of Friends Schools Annual Fall Gathering

Registration


Spring Heads Gathering

CONTACT INFORMATION

School Name / Organization
Name of Registration Contact
This person will be contacted with questions about participants or registration information.
Registration Contact Day Phone # (include area code)
Registration Contact Email Address

PARTICIPANT INFORMATION

Name
What name does the participant go by?
(example William = Bill, Kathleen = Kathy
Participant "Weather/Travel Emergency" contact/cell number:
 (In case of last minute cancellations, lateness or travel advisories) Cell phone preferred
In what Division/Department does participant work?
What is the participant's job title/subject taught?
What is the participant's E-mail address?
What pronoun does the participant use?
(example: She/He/Them etc.)
Dietary Needs:
This information is helpful to the Pendle Hill kitchen
Ominvore
Eats Fish & Chicken
Eats Fish
Vegetarian
Vegan
Dairy Free
Gluten Free
Other Allergies, etc...
Will the participant stay for lunch at the end of the gathering
 Yes, lunch at the end  No
Does particpant have any physical restrictions, special accommodations needs or any other comments:
 No  Yes
Have a topic you want discussed?
List your topic suggestion here.

PAYMENT INFORMATION

Requesting Financial Assistance?
Form Total: $0.00
Which method will you use for payment?
 

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Heads Travel Fund

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