| Attendee Information:
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Online Handle(s):
What online name(s) do you go by? |
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| Real Name (First and Last):*
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Preferred Name(s) or Nickname(s):*
Name(s) you prefer to go by offline. |
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| Email Address:*
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| Street Address:
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| City/Town:
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| State/Province/Region:*
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| Zip Code:
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| Country:*
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| Primary Phone Number:
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| Type of Phone:
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| Secondary Phone Number:
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| Type of phone:
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| YIM:
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| AIM:
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| MSN:
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| ICQ:
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| Skype:
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| Birthday (Month/Day/Year):*
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| Age:
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| Gender:
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| Jedi Gathering for which you are registering (e.g. Ohio 2006):
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| How did you hear about the Gathering?
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| How certain are you of making it to the Gathering?
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| Primary method(s) of transportation:
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| Do you need assistance with transportation?
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| Will you be carpooling with other people?
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If applicable, please list the people currently in your carpool. (Any people in your carpool, including minors, will need to fill out their own Gathering Registration forms.):
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| If carpooling, will you be a driver or passenger?
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| Are you able to provide carpool for other people?
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| If so, then how many additional people can you provide transportation for beyond those you are already carpooling with, if any?
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| For food I will:
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List any dietary restrictions or allergies you may have (e.g. vegetarian, vegan, no pork, peanut allergy, etc):
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List any workshops, discussions, or activities, you’d like to see at the Gathering.:
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List any workshops, discussions, or activities that you’d like to LEAD or assist with. You should be able to demonstrate how the workshop is relevant to the Jedi path.:
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If applicable, please list your qualifications for leading the workshop/discussion(s) listed above. You don't have to be an expert, but you should have a firm understanding and be competent enough not pass on inaccurate information.:
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| Do you require financial assistance to attend the Gathering?
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If applicable, please indicate details below.:
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| Can you provide any financial assistance for anyone attending the Gathering?
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If applicable, please indicate details below.:
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| Do you own a tent?
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| If so, how many people does it hold and are you willing and able to provide space for others?
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Please list any food or equipment that you can provide or share with the group.:
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Please write any additional notes, questions, or suggestions below.:
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| If other members from the same household are attending, you may list them below rather than submitting a separate form. You must fill out all the fields below.:
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| Online Name(s):
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| What online name(s) do you got by? (Put N/A if this doesn’t apply.):
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| Legal Name (First and Last):
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| Birthday:
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| Relationship to primary attendee:
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| Likelihood of attending:
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| If other members from the same household are attending, you may list them below rather than submitting a separate form. You must fill out all the fields below.:
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| Online Name(s):
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| What online name(s) do you got by? (Put N/A if this doesn’t apply.):
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| Legal Name (First and Last):
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| Birthday:
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| Relationship to primary attendee:
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| Likelihood of attending:
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| If other members from the same household are attending, you may list them below rather than submitting a separate form. You must fill out all the fields below.:
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| Online Name(s):
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| What online name(s) do you got by? (Put N/A if this doesn’t apply.):
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| Legal Name (First and Last):
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| Birthday:
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| Relationship to primary attendee:
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| Likelihood of attending:
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Please Note: Questions proceeded by an asterisk (*) are compulsory.
