* 1. Will you be attending the Kansas City or St. Louis Conference?

* 2. What is your full name?

* 3. What's the best number we can use to contact you?

* 4. What's the best email address we can use to contact you?

* 5. What is the name of your organization?

* 6. What is the name of the city/town from which you operate?

* 7. Will you be staying in a hotel?

* 8. How would you like your name to appear on your conference badge?

* 9. We want to help you grow and help more kids! What are the top 3 questions or issues you have that you would like addressed during the conference?

* 10. Please list any dietary restrictions you have. We will do our absolute best to accommodate you!

* 11. A limited number of scholarships are available to help cover travel costs for organizations in need. Do you require a scholarship to attend this conference?

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