Thank you for supporting the Florida LGBTA Democratic Caucus's "March Forth!" Winter Conference, hosted by the Rainbow Ridge LGBTA Democratic Caucus of Polk County! To complete your event registration, please answer the following questions and click the SUBMIT button. Your early registration allows us to reserve meals and prepare agenda materials.

After you submit your registration, you will be re-directed to the PayPal website to process your registration payment of $5.

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First Name:*

Last Name:*

Street Address:*

(Include apartment or suite number if necessary.)

City:*

State:*

(Use two-letter abbreviation.)

Zip Code:*

Telephone Number:*

Email:*

Re-enter Email:*

Are you a Caucus member or elected official?*

Yes
No

If you are an elected official, please provide title of office held:

Please indicate the event(s) that you are registering for:*

REGISTRATION AND CONTINENTAL BREAKFAST (Saturday, March 4th, 9am)
WORKSHOP (Saturday, March 4th, 10:30am)
LUNCH AND GUEST SPEAKER (Saturday, March 4th, 12pm)
MEMBERSHIP MEETING (Saturday, March 4th, 1pm)
WORKSHOP (Saturday, March 4th, 3pm)
CONTINENTAL BREAKFAST (Sunday, March 5th, 9am)
MARCHING ORDERS (Sunday, March 5th, 10am)

Meal restrictions (if any):

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