Occupy Mid-West Housing and Information Form
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INFORMATION and HOUSING form.
Folks that are planning on attending the Occupy Mid-West Conference that need housing or would like to keep updated on planning for the conference from on the ground in Detroit should fill this form out and make sure to give there Phone number and Email address.

Solidarity!

1. Name: (optional)

Name: (optional) First
Last

2. Do you need Individual housing? Or housing for a group?

Do you need Individual housing? Or housing for a group? Individual.

Group.

3. How many people including yourself need housing?

How many people including yourself need housing?

4. Will you have transportation during your visit to Detroit?

Will you have transportation during your visit to Detroit?

5. Do you have or are you willing to bring a tent?

Do you have or are you willing to bring a tent?

6. Please give Contact Information so we can communicate with you about Housing/Information (optional)

Please give Contact Information so we can communicate with you about Housing/Information (optional) E-Mail.
Phone Number.

Occupy Mid-West Housing and Information FormExit this survey

Occupy Mid-West Housing and Information Form
Exit this survey