???? Neftaly Event Registration Form Template
A simple and effective form to register participants for Neftaly’s Mental Health Awareness Campaign events, including demographic data collection.
???? Event Registration Form
???? Event Name: [Pre-filled based on the selected workshop/webinar]
???? Event Date & Time: [Pre-filled]
???? Event Location/Virtual Link: [Pre-filled]
???? Participant Information
- Full Name: ___________________________
- Email Address: ___________________________
- Phone Number: ___________________________
- Age Group: (Select one)
- ☐ Under 18
- ☐ 18-24
- ☐ 25-34
- ☐ 35-44
- ☐ 45-54
- ☐ 55+
- Location (City & Country): ___________________________
???? Event Preferences
- Which event(s) are you registering for? (Select all that apply)
- ☐ Webinar: Stress Management & Coping Strategies (Date & Time)
- ☐ Workshop: Self-Care Techniques for Mental Well-Being (Date & Time)
- ☐ Live Q&A with Mental Health Experts (Date & Time)
- ☐ Community Resource Booth (Date & Time)
- Do you have any specific questions you’d like our speakers to address?
- ☐ Yes, my question is: ___________________________
- ☐ No, I just want to listen and learn.
???? Additional Information
- How did you hear about this event? (Select one)
- ☐ Neftaly Website
- ☐ Social Media (Facebook, Twitter, LinkedIn, Instagram)
- ☐ Email Invitation
- ☐ A Friend/Colleague
- ☐ Other: ___________________________
- Do you require any accommodations (e.g., closed captions, sign language interpreter)?
- ☐ No
- ☐ Yes, please specify: ___________________________
- Would you like to receive future updates about Neftaly events and mental health resources?
- ☐ Yes, sign me up for the newsletter!
- ☐ No, just this event.
???? Consent & Agreement
By submitting this form, I agree to:
✅ Receive event details and reminders via email or phone.
✅ Participate in Neftaly’s event in a respectful and professional manner.
✅ Allow Neftaly to collect and analyze anonymous data for event improvement.
???? Signature (for in-person events): ___________________________
???? Date: ____ / ____ / 2025
???? Submit Form: [Button for digital form submissions]
???? Notes:
- This form can be used digitally (Google Forms, Typeform, etc.) or as a printable PDF for in-person registrations.
- Responses will help Neftaly tailor content, measure impact, and plan future events.
This registration form template ensures a smooth sign-up experience for participants while collecting valuable data for campaign improvement! ????????