Walker County Regional ILP Meeting
The IL Team is excited to welcome all IL Youth, Providers, & Partners to a Regional ILP Meeting in Walker County on March 14, 2026!
Please complete this registration form to let us know that you will attend.
I am attending as a:
*
IL Youth
Provider
Partner
Name
*
First Name
Last Name
Birthday
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Non-Binary
Other
Race
*
Asian/Pacific Islander
Bi-Racial/Multi-Racial
Black/African American
White/Caucasian
Other
Ethnicity
*
Latine/Latinx/Hispanic
Non-Latine/Non-Latinx/Non-Hispanix
Wish to not disclose
Email
example@example.com - If you do not have an email please put (na@na.com)
What county do you live in?
*
Who is your social worker?
Phone Number
*
If you do not have a cell phone, please let the person at check-in know.
Do you have any food allergies? Please let us know.
Submit
Should be Empty: