2016 Desert Southwest Annual Conference

Initiative for Growth and Vitality

Convenor & Recorder Registration

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* 1. What is your first name?

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* 2. Your last name?

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* 3. Your email address?

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* 4. Your district?

North

South

East

West

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* 5. How would you prefer to serve?

I would be willing to do either, whichever is needed.

I would prefer to be a CONVENER.

I would prefer to be a RECORDER.

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* 6. I am fluent in a language other than English and could convene or record at a table where the language spoken is:

Korean

Spanish

Tongan

American Sign Language

Other (please specify)

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* 7. If you are a recorder how will you complete the form?

Blue or black pen on paper form.

Online form.