Conclave T'kope Staff Interest
Thank you for your interest in helping staff the 2017 Conclave at Camp Pigott, Sep. 15-17. This form is intended to show your interest in staffing conclave and is not an actual registration form. Conclave registration is open please register using this link: If you have any questions please contact: Adam Kipust (
Email address *
Name (First and Last) *
Age/Gender *
Preferred Phone number *
Preferred Area *
Do you have any certifications/training/skills we should know about? (Ex: COPE Level 1/EMT B)
Chapter *
Any thing else we should know?
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service