| |
|
| Type of
participant | (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) |
| |
|
| 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 your guest 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 |
|
| |
|
All Participants MUST be registered, otherwise
there will not be room at the table. |
|
* We suggest families or groups attend the
Dallas Dinner Table in pairs or as singles. This
will maximize the diversity of each dinner table
and your families' or groups' experience. You
can share those experiences together at your
next meeting |
|
| |
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 Participant |
|
|
|
|
|
|
North of LBJ (I-635), west of Central, east of the
Tollway, south George Bush Freeway |
|
West of Downtown, south of 183, east of Beltline Rd |
|
|
|
|
|
|
|
|
|
| |
| |
|
| Previously Attended? |
Have you previously
attended a Dallas Dinner Table? |
| Guest Previously Attended? |
Has your Guest
previously attended a Dallas Dinner
Table? |
| Receive
DDT Newsletter? |
Would you like to receive
the Dallas Dinner Table's newsletter? |
| Willing to Volunteer? |
Would you be willing to
volunteer at the Dallas Dinner Table? |
