Marijuana Anonymous Conference 2021

Old Form

Personal and contact info

Your Name*

Your Email*

MA District/Trustee*

Home Phone

Mobile Phone*

Emergency Contact*

Relationship to Registrant*

Emergency Contact Phone*

Gender*

Mailing Address*


Housing and transportation

Accomodation

Please select your accommodation option above.

Roommate Request

Special accommodations request (if required)

Parking*

On-site parking must be requested in advance, and costs $15 for a 24 hour period starting at noon and ending at noon the next day.

Parking fees

Please select your parking option above. On-site parking at the discounted rate of $15/night must be paid in advance, and included in your check with registration fees. Parking costs $15 for a 24 hour period (noon to noon).

Pickup from Ashby BART station requested?

If you need to be picked up at BART, approximate arrival time.

Drop-off at Ashby BART station needed?

I will have a car and can help with transportation.


Food and beverage

Vegetarian, vegan, Kosher, gluten-free, or allergies? Let us know here.

Beverage Preference





Committee Assignments:
There are two groups of committees, Group A and Group B. Please choose a first, second, third, and fourth choice committee assignment for each group.

Group A: 1st choice*

Group A: 2nd choice*

Group A: 3rd choice*

Group A: 4th choice*

Group B: 1st choice*

Group B: 2nd choice*

Group B: 3rd choice*

Group B: 4th choice*


Payment: Please note, payment must be mailed directly to District 2 and must be received by May 1. See below for address.

Total Cost
250.00 USD

Make your check payable to MA District 2 and mail to:
MAWS Conference 2018
c/o John L
860 Sibert Court
Lafayette, CA 94549