Online Registration Form

* Indicates a required field.

Contact information
First Name: *
Last Name: *
Street Address: *
City: *
State: *
Zip code: *
Phone before 12/21:
Phone after 12/21: *
E-mail: *
Names of kids and their ages:

Financial information
Amount I'm paying: *
Additional amount I'm contributing toward scholarships:
(donations are much needed!)
  Please remember to mail your payment to our registrar once you have registered.
Scholarships

If you are an attender or member of a monthly meeting then before applying for a scholarship directly from New Years Gathering you must first contact your meeting to ask for assistance with the registration/travel costs for NYG. Most monthly meetings are happy to sponsor young Friends to attend Quaker gatherings. If you are not a member or current attender or if your meeting cannot afford to help you with the registration costs then please specify how much scholarship aid you will need.
Do you need scholarship assistance? Yes No

Sponsorship
Would you like a sponsor? Yes No
Are you available to sponsor? Yes No
Is there a specific person to sponsor you?
Comments?

Travel Questions
Number of rides you need:
Number of rides you can provide:
Date of departure:
Place of departure:
Comments?

Dietary Needs
Please list your dietary needs:
This is my first submission of the form
This is a revised submission of the form