You are hereUser account / User account

User account

Welcome!

Use the form below to receive an invite to one of our events from a Steering Committee contact person.

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Personal Information

Reason For Registering: *

Reason for Registering? (Please Select)

The content of this field is kept private and will not be shown publicly.

First Name: *

Last Name: *

Phone Number: *

City: *

State: *

Country: *

The content of this field is kept private and will not be shown publicly.

Contact by: *

How would you prefer other members contact you?

Other LGBT Groups & Affiliations:

List any other LGBT groups or affiliations you are a member of.

Camping Interest: *

Are you interested in our summer camping program?

The content of this field is kept private and will not be shown publicly.

Originally From: *

What US State or Foreign Country are you originally from?

Personal Message: *

We would appreciate a personal message with your request. Tell us a bit about you and why you're interested in OMEN. This will verify that the initial request came from you, and show us you are serious and not playing with this site as sometimes happens. The content of this field is kept private and will not be shown publicly.

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

How did you hear about us?:

By submitting this form, you accept the Mollom privacy policy.

To prevent automated spam submissions leave this field empty.