| Name: |
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| Email (if any): |
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| Phone number: |
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| Mailing address: |
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| Food Allergies/Dietary Needs (other than vegan/vegetarian): |
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| Number of Children & Ages:, |
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| Please list any special needs you may have (disabilities, bed, past abuse, etc.):, |
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| TRAVEL: The airport is two hours away -- please make arrangements so that you will arrive before the conference begins. Are you in need of a ride? Will you be able to attend only if you receive a financial scholarship? Would you be able to offer a ride to others? |
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All participants will be expected to do work shifts to make the conference successful. What groups would you be willing to do a work shift with? (check as many as you want to):
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Kitchen
Medical
Parking/Shuttles
Airport/Bus Station Pickup/Dropoff
Childcare
Advocates
Accessibility
Water/Wood
Hygiene/Shitters
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| Donation:(Suggested donation is $5-$100.) |
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Preferred method of payment:
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Online payment by PayPal
By mail with cash or check made out to Plan Z (Mail to Plan Z, P.O. Box 8462, Columbus, OH 43201
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| Is there a workshop you would like to present? Please state ideas, plus any additional accommodations required. |
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| Do you have any ideas for presenters? Please provide contact info and if you would like to personally coordinate the workshop. |
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| What working group would you like to be a part of? Are you interested in being a contact person/bottomliner for that group(don't be shy!!)?, |
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| What caucuses would you like to participate in?
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| What are your fears about the conference?, |
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| How can we make this a comfortable space for you and others?, |
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| What have you see that worked well at other conferences you've attended? |
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| What have you been dissappointed with at other conferences?, |
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| What would you like to see resulting from the conference? |
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We will receive your registration information when you hit the "register" button. When you hit the button it will take you to a "thanks" page. Please hit the back button on your browser to pay via paypal by clicking on the "Make a Donation" button below.