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.

First Name

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* 1. First Name

Last Name

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* 2. Last Name

Email Address

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* 3. Email Address

Which best describes your affiliation?

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* 4. Which best describes your affiliation?

Which municipality do you represent?

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* 5. Which municipality do you represent?

Do you have any dietary restrictions?

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* 6. Do you have any dietary restrictions?

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

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

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