Alliance-Training Registration Form

You must fill out this registration form for each participant.

You are registering for: .

Participant's Contact Information:

First name:
Last name:
Organization:
Email Address:
Phone Number:
Address:
City:
State:
Zip:
Potential Campaign:

Participant's Meal Preference:

No Preference
Vegetarian
Vegan
Other:

Lodging:

Information on lodging in the area will be sent upon registration.

Special Requests

Translation

Homestay (A limited number of homestays are available on a first come-first serve basis)

Interested in bike rental information (Check the box if you have interest in renting a bike during the training)

Other Special Requests:

Type of Payment for This Registration:

Online (Via Pay Pal/Credit Card/Electronic Check)
Mail
Phone (Via Credit Card)
Advocacy Advance Grants Scholarship
Other Scholarship