Transgender Veterans "March to the Wall" Registration Form

Please note:  Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to:  projects@tavausa.org.

May 20-21, 2005
Please note:  There are no costs associated directly with this registration to participate in the March.
Please read the areas of the web site regarding March details and instructions.  A registration must be completed for each person attending the March.

Name:  

Email Address:  

Address:  

City:  

State:  

Zip Code:  

Military Service Branch:  

Rank at Discharge:  

Special Needs:  

If traveling from outside of the DC area, how do you plan on getting to DC?

If traveling by personal vehicle, are you willing to take passengers?   Yes     No

Your approximate date and time of arrival (refer to schedule)
Date:  

Time:  

Are you presently a member of a Veteranís Group?   Yes     No

If yes, which groups?

I would like to attend the dinner on Saturday night:   Yes     No

Do you need assistance with the cost of a hotel room?   Yes     No

Emergency Telephone Number:  

Thank you for participating in TAVA's second annual - "March to the Wall".

    

March 2005 Homepage     Schedule of events     Accommodations
Copyright © 2003-2005 - Transgender American Veterans Association.  All rights reserved.
www.tavausa.org