Name: ____________________________________________________________

Address: __________________________________________________________

__________________________________________________________________

Phone Number: _____________________________________________________

E-mail: ____________________________________________________________

I prefer to be contacted and updated through: __e-mail __snail mail __phone (check one, but keep in mind that e-mail is easier and cheaper for us!)

Will you need a place to stay? _________________________________________

Do you have allergies to animals? Which ones?___________________________

Do you prefer non-smoking or smoking housing?___________________________

Would you be willing to camp outside?___________________________________

Will you need childcare? For how many children?__________________________

Is there anyone we know that you would prefer to stay with? __________________

Do you need anyone to meet you at the bus station/train station/airport? ________

Do you have any special dietary needs? (vegan, vegetarian, allergies, etc.) ________________________________

Can you do a workshop? If so, pertaining to what?___________________________

___________________________________________________________________

Do you need a table reserved? If so, for what? _____________________________

___________________________________________________________________

Can you perform/do you know someone who can? If so, who?

____________________________________________________________________

What are some workshop topics that you would like to see discussed?

____________________________________________________________________

Any other suggestions?

____________________________________________________________________

____________________________________________________________________

To make this a collective effort, we need your help. Would you be willing to help with security, childcare, food, cleanup, registration, etc.?

______yes, I'd like to help with___________________________________________

______no thanks

Enclosed is my: __$15 registration fee __ partial registration fee and commitment to volunteer
(Please send well-concealed cash or checks made out to Auburn Women's Organization)

When we receive your registration, we will send you a convention pamphlet and map.

Send to:

Southern Girl Convention
P.O. Box 2956
Auburn, AL 36830