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Individual Registration

* Indicates required field

Name *

First

Last

Email *

We will only send you participant information about the neighborhood project. We will not share your contact information with anyone.

Primary Phone Number *

We will only text or call you about participant information regarding the neighborhood project. We will not share your contact information with anyone.

Facebook username *

This enables us to invite you to a facebook group which will contain the most current information during the course of the training.

Dietary Restrictions for you *

Will you need childcare? *

Yes No

List names, ages, and dietary restrictions of any children. (Or if no children attending, write "none"). *

Would you or anyone in your group benefit from translation services? *

Yes, please. No.

If yes, what is the primary language of those needing translation? *

How would you like to pay the $20 registration fee (scholarships available)? *

I'd like to pay now, please! (Just follow the instructions on the confirmation page). I'd like to pay at the event. (We can take cash or check). Scholarships are available? Yes please! I am coming as a part of a group that is covering my registration.

We are fortunate to have generous donors who have covered the cost of our speakers, translators, childcare, and administrative costs, because they want to invest in the power of our community! The registration fee serves to supplement the cost of dinner for our participants.

Are you coming as a part of an organization, institution, or group? Please write the name of the group here. *

Are you able to attend all sessions? (Check all that apply) *

Yes! I will be absent for Session 1 I will be absent for Session 2 I will be absent for Session 3 I will be absent for Session 4

I would like you to make it easy for me to invite others in my community or organization. *

Yes! Please send me a flyer that I can post or email to others. Yes! Please tag me on social media posts so I can share easily without added work! No, thanks!

Submit

EMAIL

hello@storylinecommunitypdx.org

phone

503.683.2857

mailING ADDRESS

Storyline Community
PO Box 22147
Milwaukie, OR 97222