Dallas Pride® 2018 - New User Registration

First Name *

Last Name *

E-Mail Address *

Password *

Choose a strong password with a minimum length of 6 characters.

Confirm Password *

Organization Name *

Organization Type *

Non-profit
If you are a non-profit, you must upload a copy of your non-profit status to your application.

For Profit
If your funding comes from your local company’s budget.

Employee Group
If your funding is generated by the members of the Employee Group.

National Business
If your funding comes from your corporate budget.

Address 1 *

Address 2

City *

State *

ZIP Code *

Primary Contact Name *

Primary Contact Phone *

Primary Contact Email *

Alternate Contact Name

Alternate Contact Phone

Alternate Contact Email