You can always press Enter⏎ to continue
Welcome
Hi there, please fill out and submit this form.
8
Questions
START
1
Name
*
This field is required.
First Name
Initial of Last Name
Previous
Next
Submit
Press
Enter
2
Email
*
This field is required.
example@example.com
Confirm Email
Previous
Next
Submit
Press
Enter
3
Phone Number
Previous
Next
Submit
Press
Enter
4
Are you attending Assembly
*
This field is required.
Yes - In Person
Yes - Virtually
No
Previous
Next
Submit
Press
Enter
5
Are you attending Convention
*
This field is required.
Yes - In Person
Yes - Virtually
No
Previous
Next
Submit
Press
Enter
6
I am a ...
*
This field is required.
Please select an option
Board Member
Trustee Liaison
Parliamentarian
Service Body Representative
Meeting acting as a Service Body
Service Body From Another Region
Committee Chair
Service Coordiantor
Visitor / OtherSer
Please select an option
Please select an option
Board Member
Trustee Liaison
Parliamentarian
Service Body Representative
Meeting acting as a Service Body
Service Body From Another Region
Committee Chair
Service Coordiantor
Visitor / OtherSer
Previous
Next
Submit
Press
Enter
7
What is the name of your Service Body
Previous
Next
Submit
Press
Enter
8
Name of Service Body Chair
*
This field is required.
If the Chair is the representative, please choose another board member for this section. This will be used for confirmation purposes.
First Name
Initial of Last Name
Previous
Next
Submit
Press
Enter
9
Email of Service Body Chair
*
This field is required.
If the Chair is the representative, please choose another board member for this section. This will be used for confirmation purposes.
example@example.com
Previous
Next
Submit
Press
Enter
10
Is this your first time as a Region 9 Assembly?
YES
NO
Previous
Next
Submit
Press
Enter
11
Would you like a mentor (someone to help guide you through the assembly processes)?
YES
NO
Previous
Next
Submit
Press
Enter
12
Would you be willing to be a mentor (someone to help guide a new person through the assembly processes)?
YES
NO
Previous
Next
Submit
Press
Enter
13
By registering, I acknowledge that Assembly sessions will be recorded. I understand that if I choose to share at any session, my voice may be part of that recording.
*
This field is required.
Yes - I agree
Previous
Next
Submit
Press
Enter
14
I consent for my data to be transferred outside the EEA between Region 9 and Board Members and Committee Members.
*
This field is required.
Yes - I agree
Previous
Next
Submit
Press
Enter
15
I wish to subscribe to the Region 9 mailing list to receive updates from Region 9. You can unsubscribe anytime.
YES
NO
Previous
Next
Submit
Press
Enter
16
Approved
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
16
See All
Go Back
Submit