Connecting CT Connversation

Connecting CT Conversation Registration

Please complete the form below for each individual who will attend. Please note that registration is limited to no more than 100 people at each conversation.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
In What Capacity Will You Attend?*
Affiliated Organization*
Write 'none' if attending as an individual
Phone Number*
In the event we need to contact you.
I will attend:

9/25/24 (3:30-5 pm) - CT Room in Memorial Hall, Central CT State University, New Britain10/1/24 (3:30-5 pm) - Wilbur Cross North Reading Room, UConn Storrs Campus10/23/24 (3-4:30 pm) - Darien Public Library, Darien
Should be Empty:

Connecting CT Conversation Registration