On-line Registration for FSA-Hosted Events and Conferences-Individuals or Households.

On-line Registration for FSA-hosted Events and Conferences.

Instructions for FSA-xxx Online Registration Fields for FSA-Hosted Events and Conferences

On-line Registration for FSA-Hosted Events and Conferences-Individuals or Households.

OMB: 0560-0226

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Instructions for xxx-xxx

Online Registration Form for FSA-Hosted Events and Conferences



Fld Name/ Item No.

Instruction

1

Prefix

Required entry. Select name prefix of registrant from dropdown box. Choices include “Mr., Mrs., Miss, Dr., The Honorable, Rev.”

2

First Name

Required entry. Enter first name of registrant.

3

Middle name or Initial

Enter middle name or middle initial of registrant.

4

Last name

Required entry. Enter last name of registrant.

5

Email Address

Required entry. Enter email address.

6

Title

Enter title of registrant

7

Company/Organization

Enter Company/Organization.

8

Affiliation

Required entry. Select affiliation. Choices include “College/University, Cooperative Extension, Federal Government Agency, State Government Agency, Non-Profit Organization, Business, Farming, Other”.

9

Country

Required entry. Select the County of residence from the dropdown box

10

Street Address Line One

Required entry. Enter the Street address line 1.

11

Street Address Line Two

As needed, enter the second line of the street address.

12

City

Required entry. Enter the City.

13

State/Province

Required entry. Select the State or Province from the dropdown box.

14

ZIP/Postal Code

Required entry. Enter the ZIP or postal code.

15

Address Type

Required entry. Select the address type from the dropdown box. Choices include “Work Address or Home Address”

16

Phone

Required entry. Enter the 10-diget phone number including area code.

17

Invite People

Enter the first name, last name, and email address of individuals whom you would like to invite to the event. You may enter up to two individuals. In the comment box, add a short message to be included in the invitation.

18

Waivers of Claim and Release of Liability

Read the waivers of claim and release of liability. Check the box to agree to the terms.

19

Do you require specific aids or services?

Check any special service aids you may need to participate in the event.

20

Gender

Select your gender from the dropdown box. Chose from “Male or female”.

21

Veteran Status

Provide your veteran status by selecting the response from the dropdown. Choices include “No or Yes”.

22

Ethnicity

Select your Ethnicity. For this questionnaire, Hispanic or Latino origins are not races. You may select either “Hispanic or Latino” or “Not Hispanic or Latino”

23

Race

Mark all races which apply to registrant. Choices include “American Indian or Alaskan Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, White/Caucasian, Other”. If “Other” is selected, please specify.

24

How did you hear about the event?

Mark the method in which you heard about the event. Choices include “Word of Mouth, Email, Social Media, Publication, At Another Event, Other”. If “Other” is selected, please specify.

25

Choose Registration Option

Choose the registration option by selecting the desired event. Summaries of the event are included on the registration screen.

26

Submit Payment

Select the desired payment type. Complete required payment information as applicable.

Submit

Click the “Submit” button to complete the registration process.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorWatson, Shayla - FSA, Washington, DC
File Modified0000-00-00
File Created2021-01-23

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