| Type of
facilitator | (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) |
| Host
and Facilitator |
(Note:
if you are acting as both Host and Facilitator, please
go to the Host page to register. You do
not have to fill out 2 forms.) |
| |
|
| Guest |
(Will you be bringing a
guest (spouse, partner, friend) to your event?) |
| |
*
In order to to insure that you both will attend the same
dinner, you MUST
sign up together. ONLY you will be
notified the location of your joint Dinner Table.
In order to avoid double registration please make sure
that they do NOT register separately.
If you register separately we cannot guarantee you will
be assigned to the same table. |
| Guest's
First Name |
|
| Guest's Last Name |
|
| |
* The
Dallas Dinner Table recommends that all participants be
at least 18 years of age. |
| Guest's
Gender |
|
| Guest's Ethnicity |
|
| Guest's
Age |
|
| |
In what three (3) geographic
areas would you be willing to attend the Dallas Dinner
Table? |
| Choose three
geographic areas in which you would like to attend
as a Facilitator |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
| |
|
| Previously Attended? |
Have you previously attended
a Dallas Dinner Table? |
| Guest Previously Attended? |
Has your Guest (if you've
registered a Guest) ever previously attended? |
| Receive
DDT Newsletter? |
Would you like to receive
the Dallas Dinner Table's newsletter? |
|
Additional
Facilitator Requirement |
You will be asked to
participate in a mandatory orientation session. (You can
choose from 2 dates) Click
Here to Schedule your Training Date. Then return
to this page to continue your registration. |
