Please fill out and return to Carrie Tate-Meyer – carrie.d.tate-meyer.civ@mail.mil

PARTICIPANT INFORMATION

Last name: First:

Spouse’s Unit:

FRG Position:

How long have you held this position?

Will you require

Childcare?

*If you answered yes please fill out section below under

childcare

Lunch will be provided. Please mark which choice you

would like. All meals will come with your water, ice tea.

Chipotle Roast Beef Wrap

Spinach Turkey Wrap

Roasted Vegetable Wrap with Garlic Aioli

CHILDCARE INFORMATION – OFFERED FROM 8:30AM-4:00PM, MEMORIAL DRIVE CDC

Child’s last name: First: Age:

Is the child registered with CYSS?: NO YES If you answered no, childcare cannot be provided through

CYSS until the child is registered

Child’s last name: First: Age:

Is the child registered with CYSS?: NO YES If you answered no, childcare cannot be provided through

CYSS until the child is registered

Child’s last name: First: Age:

Is the child registered with CYSS?: NO YES If you answered no, childcare cannot be provided through

CYSS until the child is registered

REGISTRATION FORM

FAMILY READINESS GROUP TEAM SYMPOSIUM February 12, 2013

0900-1530

The Common’s, Fort Drum

Registration Deadline 25 January 2013

Please fill out and return to Carrie Tate-Meyer via email to carrie.d.tate-meyer@mail.mil. If you are IN NEED of

childcare the registration deadline is 25 January 2013. Registration deadline is 25 January 2013. Any questions

please email Carrie Tate-Meyer or call 772-0084