2023 Circle Registration: Individuals Please register here if you are registering as an individual. Table leaders should use the Table Registration Form to register. Questions? Please reach out to Jayati Mal, Development Coordinator, at jmal@ywcamclean.org. "*" indicates required fields Attendee DetailsAttendee Name* First Last Attendee Email* Attendee Phone*Attendee Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Are you joining a table that has already registered?* Yes No Who is your table leader? Attendee Meal ChoicePlease choose your meal option:*Meal Options: Option 1: Grilled Vegetable Entrée Marinated Seasonal Vegetables Tossed in Herbs and Spices Grilled Over an Open Flame. Served with Toasted Basmati Rice with a Zesty Bean Relish. (Vegan & Gluten Free). Option 2: Strawberry Fields Salad with Chicken Grilled Chicken, crisp Salad Greens, Strawberries, Almonds, Poppy Seed Dressing - served with rolls and butter. (Non-Vegetarian: Chicken). Choose your mealOption 1: Grilled Vegetable EntreeOption 2: Strawberry Fields Salad with ChickenDo you have Dietary Restrictions? I have dietary restrictions or allergies. Please list all restrictions or allergies we need to be aware of. May we add you to our email newsletter?* Yes! Please sign me up for YWCA McLean County monthly newsletters and other marketing updates. I am already signed up for YWCA McLean County monthly newsletters and marketing updates. No, thank you. You may unsubscribe at any time.
