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AIM FOR AMES Roundup Registration

Please preregister. Registration: $25 each A.A. / Al-Anon / Alateen
Registration via PayPal or Credit Card: PLEASE NOTE
- There is a $1.50 additional charge to cover the cost of the transaction.
- There is a limit of up to four persons per PayPal transaction.
- If you are paying for multiple registrations name and payment for each registrant is * required.
- PayPal link will be disabled 11PM, March 15th, 2023. (Registration will also be available during the conference.)
Registration via Mail - Download the conference flyer and registration form and follow mail-in instructions.
1st Registrant Information*

First Name Last Name
Select Registration Payment

$26.50
Phone Number
E-mail
example@example.com
Address

Street Address

Street Address Line 2

City State

Zip Code
Check One

A. A.Al-AnonAlateenOtherCheck if you are hearing impaired and need an interpreter
Would you like to volunteer for any 1-hour service positions (coffee, greeting, registration, etc.) during the Aim for Ames weekend? If yes, please provide contact information above.

Yes, please contact me!No, thank you.
2nd Registrant Information

First Name Last Name
Select Registration Payment

$26.50
Phone Number
E-mail
example@example.com
Address

Street Address

Street Address Line 2

City State

Zip Code
Check One

A. A.Al-AnonAlateenOtherCheck if you are hearing impaired and need an interpreter
Would you like to volunteer for any 1-hour service positions (coffee, greeting, registration, etc.) during the Aim for Ames weekend? If yes, please provide contact information above.

Yes, please contact me!No, thank you.
3rd Registrant Information

First Name Last Name
Select Registration Payment

$26.50
Phone Number
E-mail
Address

Street Address

Street Address Line 2

City State

Zip Code
Check One

A. A.Al-AnonAlateenOtherCheck if you are hearing impaired and need an interpreter
Would you like to volunteer for any 1-hour service positions (coffee, greeting, registration, etc.) during the Aim for Ames weekend? If yes, please provide contact information above.

Yes, please contact me!No, thank you.
4th Registrant Information*

First Name Last Name
Select Registration Payment

$26.50
Phone Number
E-mail
example@example.com
Address

Street Address

Street Address Line 2

City State

Zip Code
Check One

A. A.Al-AnonAlateenOtherCheck if you are hearing impaired and need an interpreter
Would you like to volunteer for any 1-hour service positions (coffee, greeting, registration, etc.) during the Aim for Ames weekend? If yes, please provide contact information above.

Yes, please contact me!No, thank you.
Calculation
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If you experience problems completing and/or submitting this form please email aimforames@yahoo.com
Amount to be paid

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