Ujamaa Place Event Guest Registration Form

Thank you for your interest in attending our virtual event on October 7th, 2021. We are excited for you to hear the amazing stories of our Ujamaa Men. Registered guests will receive information about how to access this virtual event as the date nears. Please note: If you have already registered as a Table Host you do not need to register again.

Guest Information

First Name

Last Name

Email Address

Mobile Number

Mailing Street

Mailing City

Mailing State

Mailing Zip Code

If you were invited by a Virtual Table Host please select their name:

Note: Your Table Host's name may not be on this list for up to 48 hours after they register as a Table Host. If you would still like to register now you may select "Other" and put their name in the Comments.

If you need any accommodations (ex: sign language interpreter) please detail those here so that we can strive to make our event as accessible as possible:

Comments:

Contact Information