***Please put a check mark by the information that you do NOT want us to put in a public directory. Any checked information will be for encuentro organizers only.***
(Keep Private) Name: (Keep Private) Phone: (Keep Private) Phone 2 (please specify cell, work, etc.): (Keep Private) Email: ) Email again: (Keep Private) Address Line 1: (Keep Private) Address Line 2: (Keep Private) City: (Keep Private) State: (Keep Private) Zip/Postal Code: (Keep Private) Country: (Keep Private) Organization(s): (Keep Private) Website:
MEALS:
I would like the following meals:
Saturday, Nov. 13, breakfast Saturday, Nov. 13, lunch (note: Friday night and Saturday afternoon snacks will be provided)
Vegan Vegetarian Meat Other:
CHILDCARE:
Do you need childcare Saturday (Nov. 13)? If so, please enter # of children, ages, and times childcare is needed: (Please note: People doing childcare are volunteers and may not be "certified babysitters.")
For those coming from out of town:
Do you need HOUSING Friday night? Y N If yes: Sleeping Needs (floor, couch, bed): Alergies: Do you have a car? Y N (limited Saturday night housing is available, please contact us if needed)
I would like to apply for transportation reimbursement and will contact WoGAN at: WoGANemail@yahoo.com or (508) 335-7783.
TABLING:
I would like half of a table to display during the encuentro and will contact WoGAN with space needs at: WoGANemail@yahoo.com or (508) 335-7783.
Any other comments?