| First Name * First Name |
|
| Last Name * Last Name |
|
| Address Line 1 * Address Line 1 |
|
| Address Line 2 Address Line 2 |
|
| City * City |
|
| State/Province * State/Province |
|
| Zip Code/Postal Code * Zip Code/Postal Code |
|
| DayPhone * DayPhone |
|
| Is this your * Is this your |
Home |
|
Work |
|
Cell |
| Evening Phone Evening Phone |
|
| Is this your Is this your |
Home |
|
Work |
|
Cell |
| EMail * EMail |
|
| How would you like to be contacted? How would you like to be contacted? |
Email |
|
Day Phone |
|
Evening Phone |
| Gender Gender |
|
| I am interested in the following sport * I am interested in the following sport |
|
| Select an information meeting to attend
|
Meetings Available in your Area:
| Topeka |
| Thu,01-14-10, 6:00PM
SU2010 Topeka 01/14/2010 FY2010
Topeka Public Library
1515 SW 10th Avenue
Topeka,KS,
|
| Tue,01-19-10, 5:00PM
SU2010 Topeka 01/19/2010 FY2010
Topeka Public Library
1515 SW 10th Avenue
Topeka,KS,
|
| Tue,01-19-10, 6:00PM
SU Topeka Kick Off 01/19/2010 FY2010
Topeka Public Library
1515 SW 10th Avenue
Topeka,KS,
|
| Wichita |
| Tue,01-12-10, 6:00PM
SU2010 Wichita 01/12/2010 FY2010
Larksfield Place
7373 East 29th Street, North
Wichita,KS,
|
| Wed,01-13-10, 6:00PM
SU2010 Wichita 01/13/2010 FY2010
Wesley Medical Center-Jayhawk Conf Rm
550 North Hillside
Wichita,KS,
|
| Sat,01-16-10,11:00AM
SU2010 Wichita 01/16/2010 FY2010
Alford Branch Public Library
3447 South Meridian
Wichita,KS,
|
| Thu,01-21-10, 5:00PM
SU2010 Wichita 01/21/2010 FY2010
Wesley Medical Center-Jayhawk Conf Rm
550 North Hillside
Wichita,KS,
|
| Thu,01-21-10, 6:00PM
SU2010 Wichita Kickoff 01/21/2010 FY2010
Wesley Medical Center-Jayhawk Conf Rm
550 North Hillside
Wichita,KS,
|
|
|
|
| Select an event you are interested in Select an event you are interested in |
|
| Are you planning on Bringing a friend? Are you planning on Bringing a friend? |
|
| If yes, what is your friend's name? If yes, what is your friend's name? |
|
If you received a mailing about Team In Training, please provide us with the following information from the mailing label:  |
| Participant Code (found in top left corner of mailing label) Participant Code (found in top left corner of mailing label) |
|
| Source Code (found in top right corner of mailing label) Source Code (found in top right corner of mailing label) |
|
| Are you a TNT Alumnus? Are you a TNT Alumnus? |
|
| What was the primary way you heard about Team In Training? * What was the primary way you heard about Team In Training? |
|
| If you heard about Team In Training through one of our corporate sponsors or partners, which company was it? |
|
| I am an employee of this company's national team I am an employee of this company's national team |
|
| I am interested in starting a Friends/Family/Corporate Team. I am interested in starting a Friends/Family/Corporate Team. |
|
| Comments |
|
| The Society respects your privacy |