DeSoto Dining and Dialogue

PARTICIPATION

How you can participate?

Our next DeSoto Dinner and Dialogue Event is

Saturday, September 25, 2010

The deadline for participant registration is: September 10, 2010

Guest Reservation Form

You may also download and print the form here (in PDF format), then fax it to:

972-230-5793

(note: to view PDF files, you must have Adobe Reader installed.)

Guest Information

Name:
Address:
Day Phone:
Evening Phone:
Email Address:
Age Range:
Ethnic Background:
Domestic Status:
Accompanying Guest Information
Name:
Address:
Day Phone:
Evening Phone:
Email Address:
Age Range:
Ethnic Background:
Domestic Status:

Dietary Restrictions:

Please choose from the roles below and tell us how you would like to participate (as a guest, facilitator or host). Also, include your full name, address, phone number and email address so we may contact you. Guests must include age and ethnicity as well as any dietary restrictions.

Note: Contact information submitted to DeSoto Dining and Dialogue will NOT be shared with any third parties or used for any purpose other than the DeSoto Dining and Dialogue program.

FACILITATOR:

Lead a group discussion - Details

HOST:

Organize the dinner event - Details

GUEST:

Join in a discussion - Details

Please allow a couple of days for a reply. Please include a contact phone number so you can be reached. Thank you for your involvement and participation.