REGISTRATION FORM (IN-PERSON PARTICIPATION)

Name*
First Last
Organization*
Phone*
Email*
Date of Event*
MM slash DD slash YYYY
Is this your first AZilg meeting?*
- Yes
- No
Are you a paid AZilg member?*
- Yes
- No
Would your organization be willing to host an upcoming monthly meeting location?
- Yes
- No
- I will let you know via info@azilg.org if possible