Universal Circle of Women Home Page

Circle Registration Form

Please enter the number of Women being registered in this circle (including Convener):
Convener's Information
First Name:
Last Name:
Email Address:
Telephone Number (include area code):
Street Address:
City:
Province/State:
Postal Code/Zip Code:
Other Circle Members' Information:
First Name:
Last Name:
Email Address:
Telephone Number (include area code)

First Name:
Last Name:
Email Address:
Telephone Number (include area code)

First Name:
Last Name:
Email Address:
Telephone Number (include area code)

First Name:
Last Name:
Email Address:
Telephone Number (include area code)

First Name:
Last Name:
Email Address:
Telephone Number (include area code)

First Name:
Last Name:
Email Address:
Telephone Number (include area code)

First Name:
Last Name:
Email Address:
Telephone Number (include area code)

Meeting Details
Day of the week you will meet:
Time you will meet (include a.m. or p.m.):
Choose the location(s) you will be meeting:
alternating members’ homes
one member’s home
rented facility
other (please specify)
Start Date:
End Date: