If you are interested and willing to be a local contact person for the Society, please complete the following points. You can enter your replies using the comment button at the bottom, or by sending me an email at firstname.lastname@example.org.
1. I confirm that I am willing to be a local contact person for the Society, and that it's OK to list my name in the website. My name is:
2. My preferred contact method is:
3. My current telephone number and/or email address is:
4. Here is a brief description of Society activities in my area (max 100 words.) (Note: We will update this information at the Office as needed.)
Note: Ideally, there should be a single point of contact for each location. If there are other groups or active individuals in your immediate vicinity, please contact them and agree on who will be the contact person.