2022 WDVA Women Veterans Retreat Attendee Registration Survey

1.Please Provide the Following Contact Information(Required.)

First & Last Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

2.Email:(Required.)

3.Will you be bringing a guest with you? (Required.)

Yes

No

4.If yes, how many additional guests will be joining you (up to five additional guests may join you)? Information required for hospitality planning purposes.

Please provide the first & last names of each guest attending

Guest one

Guest two

Guest three

Guest four

Guest five

5.Would you be interested in registering a child/children for Kids' Corner activities? Complimentary care maybe available for children ages 5-10.(Required.)

Yes

No

6.Will you be attending S'mores Around the Campfire Friday, June 3, 2022, 6:00 PM - 8:00 PM?(Required.)

Yes

No

Rooms have been reserved at the Holiday Inn Express & Suites:

2703 Craig Road

Eau Claire WI

(715) 839 - 7852

To ensure that you receive the special conference rate, it is recommended that you contact the hotel directly or register online using the following link: Click here to reserve a room at Holiday Inn Express West I94 before May 3, 2022.

Be sure to specify that you are associated with the Wisconsin Department of Veteran Affairs Female Veteran Retreat.