87th Annual Membership Meeting Registration Please enable JavaScript in your browser to complete this form.Name *FirstLastPlease indicate if registrant is a….MemberGuestPartner/Relative/Housemate/Friend of a memberAffiliation / EntityIf you are attending as a guest, please indicate the entity with which you are affiliated (e.g., VEC, State government).Member NamePlease provide the name of the Co-op member you will be attending with.EmailPhone *Account or Map # Add attendees?Yes Name of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/Housemate/Friend of a memberMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential. Add another attendeeName of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/Housemate/Friend of a memberMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential. Add another attendeeName of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/HousemateMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential. Add another attendeeName of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/HousemateMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential.Comments or QuestionsPlease let us know if you have accessibility needs or dietary restrictions. Register Please enable JavaScript in your browser to complete this form.Name *FirstLastPlease indicate if registrant is a….MemberGuestPartner/Relative/Housemate/Friend of a memberAffiliation / EntityIf you are attending as a guest, please indicate the entity with which you are affiliated (e.g., VEC, State government).Member NamePlease provide the name of the Co-op member you will be attending with.EmailPhone *Account or Map # Add attendees?Yes Name of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/Housemate/Friend of a memberMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential. Add another attendeeName of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/Housemate/Friend of a memberMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential. Add another attendeeName of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/HousemateMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential. Add another attendeeName of additional attendeeFirstLastPlease indicate if additional attendee is a…Select…MemberGuestPartner/Relative/HousemateMinorAge of additional attendeeSelect…birth – 5 years6 – 13 years13 – 17 yearsThis is for administrative purposes only and will be kept confidential.Comments or QuestionsPlease let us know if you have accessibility needs or dietary restrictions. Register
