CI-PNW 2021 Online Registration
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General Information
Registration Type *
Enter Full Name *
(First and Last)
Enter Preferred Name
This will be used for your name tag
Indicate *
Indicate Gender Pronouns *
Select Grade Level *
Date of Birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Will you be attending the entire duration of CI-PNW (Dec 27-30): *
If "Other," please indicate which day(s) you are participating
Required
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