Self Determination Banquet

register to attend below!

Tuesday June 3, 2025
5:30 PM
Location: Silvermoon Banquet Hall
137 Silvermoon Ln, Lewisburg, PA 17837

Register now! Limited to the first 200 registrants!!!
Register BEFORE May 20th for the banquet

self determination banquet attendee Sign-up Form

Fill out and submit this computer form or email [email protected]

There is no cost to event

* Indicates required field

Self Advocate Name *

First

Last

Home Address *

Email *

Phone Number *

Names of staff (if any) attending. If you are an agency bringing several people, list all here noting names that are self advocates *

Total number attending *

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register to attend below!