Register | Old Lesbians Organizing for Change

Form Submission Methods

1. Mail the form and check to:
OLOC, P. O. Box 100129, Cranston, RI 02910

2. Use the Donate button to the right to pay by PayPal or by credit card when you mail the form or when you submit the digital form below. Include your PayPal transaction ID on the registration form once you’ve paid.

3. For more private payment by credit card, contact Ruth Debra at 760-318-6794, or email your phone number (ruth@oloc.org) and she’ll phone you.

4. Registering online:

Fill out the registration form below. If you plan on using PayPal scroll down to Step 2 to figure out your total and use the donate button on the right to pay. Be sure to copy the transaction number as you will need it before you submit this form.

STEP 1: Tell us about you. Please print exactly as you want to be listed.

First and Last Name (required)

Date of Birth (required)

Street Address (required)

State/Country (required)

Phone (required)

Age as of 8/21/2019 (required)

City (required)

ZIP/POSTAL (required)

Email (required)

__________________________________
Do you plan to attend the Old Lesbians of Color Day on August 21? YESNO
It is free for all Old Lesbians of Color, including lunch. For LOC not from the Columbus area, a hotel room (with a roommate) will be provided.
Roommate's Name

__________________________________

Would you like for OLOC to help you find a roommate for Old Lesbians of Color Day and/or the entire Gathering?
YESNO

How did you hear about this event?

Do you need any specific services to assist with disabilities? If yes, please describe:

Emergency Contact Name if you become ill or need help (required)

Emergency Contact Phone (required)

Would you be willing to volunteer to assist during the Gathering?

STEP 2: Registration fee covers programs, entertainment, a welcome reception and three lunches. It does not cover housing, transportation other than local shuttle, or evening meals.

STEP 3: PAYMENT
OLOC is using a sliding fee scale for registration this year. Even the highest fee ($500) does not pay the full cost of the Gathering. We are asking you to pay the highest fee you can. What you decide to pay will be confidential.

REGISTRATION FEE $350–500
OLOC Membership $35–100 (optional, includes two different newsletters)

Contribution for financial assistance (optional, but much appreciated)

TOTAL

If you used PayPal, please include the transaction number

If you use PayPal, please include your transaction ID on the registration form once you’ve paid.