JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
J.O.Y Event - The Senior Social
Event Timing: 5pm - 9pm | May 23rd, 2022
Event Address: Centennial Pavilion - 620 Poirier Street, Coquitlam
Contact us at (604) 469-0226 or
info@lowentropy.org
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Confirm Email
*
Your answer
Phone Number
*
Your answer
What city do you live in?
*
Your answer
What is your age?
*
Under 55
Between 55 to 60
Between 60 to 65
Between 65 to 70
Between 70 to 75
Between 75 to 80
Between 80 to 85
85 over
Other:
Will you be brining anyone with you to the event?
*
Yes
No
Other:
If you are bringing a guest(s), please advise who you will be brining.
Your answer
Do you need a ride to and from the event
Yes
No
Maybe
Other:
Clear selection
How did you hear about this event?
Your answer
Do you have any comments or questions for us?
Your answer
FREE HAIRCUT - OPTIONAL
J.O.Y Project has partnered with local hairstylists who will be offering FREE haircuts to our J.O.Y members. If you'd like to freshen up your look just in time for our first J.O.Y Social please indicate your interest below and we'll contact you to set up your hair appointment.
Would you like a FREE haircut/style?
Yes, I'm interested in a FREE Haircut/style
No thank-you
Maybe
Other:
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Low Entropy.
Report Abuse
Forms
