Individual Registration

Personal Information
Name *
Name
Please provide your first and last name
Phone Number *
Phone Number
Please provide your preferred phone number
Address *
Address
Please provide your mailing address
Emergency Contact Information
Emergency Contact Name *
Emergency Contact Name
Please provide the first and last name of your emergency contact
Emergency Contact Phone Number *
Emergency Contact Phone Number
Please provide the best phone number to reach your emergency contact
Please provide your relationship to your emergency contact
Conference Information
Please select a branch of the Vincentian Family you will represent at the VFG Conference.
Please explain any use of "Other" in the drop down menu
Lodging *
Please provide your lodging plans for the VFG Conference.
Dietary Restrictions *
Please provide any dietary restrictions.