Regional Meeting Registration - Berkshires

Wednesday, June 13, 6:00pm - 8:00pm Lichtenstein Center for the Arts

Thank you for registering for the Berkshire Regional Meeting, Wednesday, June 13th at the Lichtenstein Center for the Arts, Pittsfield, MA. If you have any comments not covered in this registration form, or need special accommodations, please contact Lisa Simmons at lisa.simmons@art.state.ma.us or 617-858-2707.

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Which best describes your affiliation?

Local Cultural Council

Cultural District

Municipality

Community Foundation

Regional Planning Agency

Other (please specify)

Regional Meeting Registration - Berkshires

Wednesday, June 13, 6:00pm - 8:00pm Lichtenstein Center for the Arts

Question Title

* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Which best describes your affiliation?

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* 5. Which municipality do you represent?

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* 6. Do you have any dietary restrictions?

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* 7. Do you have any accessibility requests or needs we should be aware of?