| |
|
| Type
of host |
(required) |
| First Name |
(required) |
| Last
Name |
(required) |
| Address |
(required) |
| City |
(required) |
| State |
(required) |
| Postal
Code |
(required) |
| Home Phone |
(required) |
| Work
Phone |
(required) |
| Gender |
(required) |
| Age |
(required) |
|
Ethnicity |
(required) |
| |
Please
provide us with the location specifics
of where you plan on hosting. |
| Location Name |
( required - where
will you be hosting: your residence,
a restaurant, a church) |
| Location Address |
( required - The location
address) |
| Location City |
( required - The location
city) |
| Location State |
( required - The location
state) |
| Location Zip |
( required - The location
zip) |
| Location Phone |
( required - The location's
phone) |
| Host
and Facilitator Combo |
(Would you be willing to act as both
Host and Facilitator at your dinner
table?)
In
order to insure an excellent experience
for our guests, if you plan to Host
and Facilitate, the Dallas Dinner
Table STRONGLY suggests that you
ask your spouse, partner or guest
act as Co-Host, taking the Host
responsibilities while you act as
Facilitator. |
| |
To
assist us in the table matching process,
please select the geographic area representing
the area your dinner will be held.
|
| Host Location |
|
| Seats |
(Please indicate the total number
of seats you plan for your table.) |
| |
*
As a host, you are allowed one (1)
guest at your table. If you intend
to host your dinner with a spouse,
partner, or friend they MUST BE registered
with you. This one guest rule allows
us to obtain maximum diversity at
each table. If you have a larger family,
we suggest you split up and attend
various dinners and come back together
later to discuss your experiences. |
| Guest |
(Do you plan on including a guest at
your table?) |
| |
*
The Dallas Dinner Table recommends that
all participants be at least 18 years
of age. |
| Guest's
First Name |
( required - only
if the above answer was yes) |
| Guest's Last Name |
( required - only
if the above answer was yes) |
| Guest's
Gender |
( required - only
if the above answer was yes) |
| Guest's Ethnicity |
( required - only
if the above answer was yes) |
| Guest's
Age |
( required - only
if the above answer was yes) |
| |
|
| Hosted Before? |
Have you previously hosted a
Dallas Dinner Table? |
| Previously Attended? |
Have you previously attended
a Dallas Dinner Table in another capacity? |
| Guest Previously Attended? |
Has your Guest previously attended
a Dallas Dinner Table? |
| Receive
DDT Newsletter? |
Would you like to receive the
Dallas Dinner Table e-mail newsletter? |