NMD Interest Form

Northern MI DeColores Interest Form
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Type
Email
example@example.com
Gender
Original Weekend #
Include other group name if not Northern Michigan DeColores
Date of Weekend
Month/Year
Have you attended a 4th day workshop?
Weekends Worked
List all positions held & talks you have given
Inside Team: I would be willing and interested in doing any of the checked positions, if asked:
I am a musician and I play:

Other
I can fill an Inside Team position on short notice:
Outside Team: I would be willing and interested in doing any of the checked positions, if asked:
I can fill an Outside Team position on short notice:
Board Positions: I would be willing and interested in serving in the checked positions:
Should be Empty:

Northern MI DeColores Interest Form