Circle your 1st, 2nd, and 3rd choice selection for each of the three sessions.
Session A 9:45am – 11am
Session B 11:15am – 12:30pm
3rd Choice B1 B2 B3 B4 B5 B6
1st Choice C1 C2 C3 C4 C5
|Registrations accepted with a check or
PO# only. $15 before May 23 | $20 after May 23Mail or fax this form with a check payment or
PO #________ to:
Fax – 207-878-3172
Attn: HOPE Conference
Conference volunteers who sign up by
city, state ____________________________ zip___________
I identify as a: ¨ Peer/Consumer ¨ Provider ¨ Consumer and Provider
___I will need an American Sign Language Interpreter.
___I will be accompanied by an attendant.
___ I live 130 or more miles one way from the Augusta Civic Center and qualify for lodging reimbursement. Peers and Consumers ONLY
___I live 150+ round trip miles away and traveled in my own vehicle. Peers and Consumers ONLY
I am able to volunteer during the week of May 21___or the day May 30 ____ Contact Melissa Caswell at email@example.com