Thank you for supporting the Florida LGBTA Democratic Caucus's Winter Conference, held in conjunction with the 2018 Leadership Dinner! 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 application, you will be re-directed to the PayPal website to process your conference registration payment of $20.

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First Name:*

Last Name:*

Email:*

Re-enter Email:*

Street Address:*

(Include apartment or suite number if necessary.)

City:*

State:*

(Use two-letter abbreviation.)

Zip Code:*

Telephone Number:*

County of Voter Registration:*

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

WELCOME RECEPTION (Friday, March 9th)
CONFERENCE/BREAKFAST (Saturday, March 10th)
LUNCH (Saturday, March 10th)
MEMBERSHIP MEETING (Saturday, March 10th)
FAREWELL BRUNCH (Sunday, March 11th)

Meal restrictions (if any):

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