REGISTRATION FORM

MARCH FOR WOMEN

LAST NAME:

FIRST NAME:

CALL ME

Email:

CELL: 

OFFICE:

HOME:

ADDRESS:

About yourself:
Information you would like to share and would like others to know about you

Areas of interest and hobbies:

Special Skills and Talents: If any

Is there some skill that you would like to teach others

DO YOU HAVE A COMPUTER AT HOME                                                             YES              NO

DO YOU HAVE INTERNET ACCESS AT HOME                                                    YES              NO

ARE YOU INTERESTED IN DIGITAL LITERACY INFORMATION SESSION        YES             NO

ANY OTHER COMMENTS