2026 Convention Registration

2026 People First of Washington Convention Registration
Important

Do not submit more than one registration.

If you have to make changes contact Robert Martin robert@pfow.org or 206-660-9236.
Name*

First NameLast Name
DupChecker
YesNo, please use this name for my name badge instead:
Real inclusion means that people with disabilities have equal access to information and support to understand and use it in their own lives.
NoYes, I have asked this person to help me and and we are doing it together. Here is their contact information:
Name of the person filling out this form for the applicant:
Email of the person filling out this form for the applicant:
Phone number of the person filling out this form for the applicant:
Please include area codeFormat: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
State
Zip Code*
Phone Number*
Please include area codeFormat: (000) 000-0000.
Email
18 and under18-2122-3031-4041-5051 or aboveI prefer not to say
FemaleMaleI prefer not to sayI am:
AsianBlackLatinoMulti-RacialNative AmericanWhiteI prefer not to sayI am:
Live AloneWith ParentsLive with Partner and/or ChildrenAdult Family HomeSupported LivingI prefer not to sayMy situation is:
I am a People First of Washington member.I would like to join People First of Washington.I want to attend but do not want to join People First of Washington.
I am a member of the following chapter:*
Name of caregiver who will be with you at the convention, if you know it, or the caregiver's agency.
Yes, I will have a caregiver with me at the convention.No, I will not have a caregiver attending the convention.I am a caregiver and will be attending will be caring for:
Phone number of caregiver who will be with you at the convention, if you know it.
Please include area code.
No one. (Please note: single occupancy increases convention cost.)I will room with my caregiver.I am open to sharing a room with someone else (People First can decide who).I would like to share my room with the following person/people:
Names of people with whom I would like to share:
No, I have no dietary preferences.Yes, I do have dietary preferences.
Diabetic DietVegetarianGluten-freeDairy-freeVeganKosherNo PorkOther
If you have any other safety concerns or conditions such as blood sugar or seizures, etc., that may put you at risk of emergency, please let us know here:
Emergency First and Last Name*
Emergency Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
NoYes
No stairsI would like a wheelchair if one is availableBars around toiletRoll-in showerBath chairWalk-in showerBed clearance for hoyer liftFirst floor if possibleAccessible parkingAdjoining roomsI will be bringing my service animalI will be bringing a therapy or other petVirtual attendance through ZoomOther
No, I don't need help planning my transportation.Yes, I'll need help figuring out my transportation.
Please feel free to share any additional information you'd like us to know:
We want to make sure everyone is included in People First of Washington activities. If you have any questions, please contact Robert Martin at 206-660-9236.
I confirm I have read this statement and agree.Please contact me to talk about this.
I will send a check (mail to: People First of Washington, P.O. Box 11953, Olympia, WA 98508), or will contact Robert Martin at robert@pfow.org or call him at 206-660-9236 to make other arrangements.I need a scholarship if one is available. Members must contact their county coordinator to request a scholarship (if available).I have a scholarship—OTHER THAN FROM MY COUNTY—and will fill in the amount and donor name or agency below.I am paying by credit card below. Non-refundable processing fees apply.
Scholarship Amount:
Scholarship will be provided by:
To complete this registration, please type your name here:
Name*
Signature Date:*

MonthDayYear
Please choose one of the following options (prices include non-refundable processing fees):
prevnext( X )
Convention Attendance—Double Occupancy
You will share a room.

$478.00 Quantity

Convention Attendance—Single Occupancy
You will have your own room

$618.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

2026 People First of Washington Convention Registration