Community Action Works

Local Environmental Action Individual Registration Page

Thanks for your interest in Local Environmental Action 2015! We've tried to make this registration page simple, but please feel free to call Bess with questions at 617-747-4362. Please be aware that this page is only for your information, and at the end you'll be directed to payment options. Please also note, early bird prices end February 13th. Register today!

First Name*

Last Name*

Email*

Phone*

Street*

City*

State/Province*

Zip/Postal Code*

How did you hear about the conference?

Please select a response

What community group/organization are you part of? (if any)

Answer below

What are you buying today?

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How many tickets at the individual rate are you buying? ($40 each)

Please select a response

If these tickets are for others besides yourself, who are they for?

Please provide all full names

How many tickets at the student rate are you buying? ($20 each)

Please select a response

Are you able to make an additional donation to the Local Environmental Action scholarship fund?

Please select a response

Add up the amounts for tickets and donations. Enter that amount here, and remember it for payment.

(For example, registering three individuals at $40 each is $120 total)

How do you want to pay?

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Do you have other questions or comments?

Answer below

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Local Environmental Action Individual Registration Page

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