Chapter Development Regional Workshop – Session #3 Complete the following to register for the Chapter Development Workshop in Jacksonville. Participant's Contact InformationName* First Last Email* Enter Email Confirm Email Cell Phone*For Chapter:*Which chapter do you represent? AtlantaAustin-San AntonioBostonBrandywine ValleyChattanoogaCincinnatiCISV USAColumbusDallas/Ft. WorthDetroitGreater SpringfieldJacksonvilleMaineMiamiMidwest Ohio (Miami Cty)Michigan City-LakeshoreNew YorkNorth East OhioPhiladelphiaPittsburghPortlandRocky Mountain DenverSan FranciscoSmoky MountainSouthern CaliforniaSouthwest FloridaWashington DCChapter Role*Adult Board MemberAdult Board PresidentAdult Board President ElectChapter Development MemberJunior Branch AdvisorJunior Branch Board MemberJunior Branch LJRJunior Branch LJR ElectTravel InformationI will need hotel accommodations for:*Friday night onlySaturday night onlyBoth Friday and Saturday nightRoommate PreferenceEnter name(s) or None. This is not applicable for all training sites. Arrival Plans*Specify if driving or enter flight information, including destination airport, airline, flight number, date/time, airport from which you are coming.Departure Plans*Specify if driving or flight information, including airline, flight number, date/time, airport to which you are flying.Personal InformationAge at Time of Workshop*Dietary NeedsMy gender is*I will be 18 or over at the time of training.*Participants under 18 must complete the CISV USA Youth Legal Form signed by their parent or guardian. Bring this to the training. Your training registration confirmation email will contain a link to the form. YesNoEmergency Contact* First Last Emergency Contact Phone*Attendance*I will arrive to the training site no later than 10 am Saturday morning and will remain on site until 12 pm Sunday. Attendance AgreementSignatureCommentsThis field is for validation purposes and should be left unchanged.