Jan 04 2023 Untitled Document 2003 CrossRoads Conference Online Registration Form General Information There will be three pages to complete. You will be guided through the registration process. Once you have started please complete all three pages. You will receive an e-mail confirmation within 48 hours. If you have questions or problems with the online registration please contact Chuck Double [email protected] by phone at (614) 224-8146 Ext. 31 Fields with an * are Required fields. *First Name *Address Line 1 *Last Name (As it will Appear on Name Badge) Address Line 2 *City *Title (As it will Appear on Name Badge) *State (Two Letters Only) *Zip Code ( 5 or 9 digits allowed *Name of United Way Represented *MetroSize or Enter: STO for State Organization UWA for United Way of America *E-mail Address *Phone Ex. 6142248146 *Fax Ex. 6142248146