| |
|
| 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? |
