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YOUR CART
District Deputy Seminar
December 6 - 8, 2024
DD Seminar Response Form
*
Indicates required field
Name
*
First
Last
Member Number
*
Position / District
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Contact Number Number
*
Email
*
Are you attending
*
Yes
No
I am staying overnight
*
Thursday
Thursday, Friday
Thursday, Friday, Saturday
Friday
Friday, Saturday
Saturday
Not Staying at Hotel
Is your Spouse Attending
*
Yes
No
Are you attending Dinner on Friday
*
Yes
No
Spouse's Name
*
Turnpike Enter / Exit Interchange
*
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