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To help us prepare for the North Coast Regional Forum on April 17th, please answer a few quick questions.

Please note that we will collect $10 for the working lunch.

If you would like to invite others to the session, you may forward this RSVP form to them as well.

If for any reason your plans change, please email us at talbot.judie@gmail.com.

Question Title

* Will you attend the April 17th, 2013 North Coast Forum? (The Forum begins at 10:00 a.m. and ends at 4:00 p.m.)

	All-Day (yes for lunch)	All-Day (no for lunch)	Am Only	PM Only	No
Eureka	Eureka All-Day (yes for lunch)	Eureka All-Day (no for lunch)	Eureka Am Only	Eureka PM Only	Eureka No
Fort Bragg	Fort Bragg All-Day (yes for lunch)	Fort Bragg All-Day (no for lunch)	Fort Bragg Am Only	Fort Bragg PM Only	Fort Bragg No
Santa Rosa	Santa Rosa All-Day (yes for lunch)	Santa Rosa All-Day (no for lunch)	Santa Rosa Am Only	Santa Rosa PM Only	Santa Rosa No
Tule Valley	Tule Valley All-Day (yes for lunch)	Tule Valley All-Day (no for lunch)	Tule Valley Am Only	Tule Valley PM Only	Tule Valley No
Weaverville	Weaverville All-Day (yes for lunch)	Weaverville All-Day (no for lunch)	Weaverville Am Only	Weaverville PM Only	Weaverville No
Yreka	Yreka All-Day (yes for lunch)	Yreka All-Day (no for lunch)	Yreka Am Only	Yreka PM Only	Yreka No
Remote (via webinar)	Remote (via webinar) All-Day (yes for lunch)	Remote (via webinar) All-Day (no for lunch)	Remote (via webinar) Am Only	Remote (via webinar) PM Only	Remote (via webinar) No

Other Comments (for example, web only)

Question Title

* Tell us a little about yourself.

Your Name:

Email:

Organization/Agency:

Question Title

* If you have any additional comments, please use this box.

If your plans change, contact Judie Talbot at 775.720.0214 or talbot.judie@gmail.com.