Registration

$10 registration fee includes dinner and all materials

Name:	(first)	(last)
Address:
City/State/Zip:
Phone(s):
e-mail:
Do you need us to send you a copy of the Draft Agenda? Yes, please. No, thanks.
The registration fee is $10. Please check one of the following: I'll send a check. I'd like to pay online. I'd like to talk to someone about a reduced fee.
Please let us know how you heard about the Wake County Assembly:

Special needs, dietary requirements or other comments: