| First Name: |
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| Last Name: |
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| Email: |
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| City: |
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| State: |
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Verify your phone number:
(xxx-xxx-xxxx) |
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| For which workshop are you registering? |
NOTE: If you workshop isn't listed here, your
OLT workshop questionnaire can be
found here. |
| In case of an emergency,
please provide us with the following information: |
Name: |
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| Relationship: |
|
Phone:
(xxx-xxx-xxxx) |
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| Transportation information -- we strongly encourage carpooling. Check one of the following:
|
Driving on my own
Willing to offer rides
Need a ride
Flying, but getting to the facility on my own
Flying and need travel arrangements to the facility
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If you selected "Willing to offer rides", how many can you take?
If you selected "Need a ride", enter your departure/pick-up city. |
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| Dinner and lodging is provided the night
prior to class-start. Do you plan on taking advantage of the
food/lodging option? |
Yes No |
| Food/lodging comments? |
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Special dietary needs for meals Friday
through Sunday:
(Vegetarian, vegan, diabetic, food allergies, leave blank if none.)
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| Other Comments/Questions? |
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