diff --git a/conservancy/summit_registration/models.py b/conservancy/summit_registration/models.py
new file mode 100644
index 0000000000000000000000000000000000000000..ae2e8b3a22aeedd9e92d74b30b93c3531cf7d33d
--- /dev/null
+++ b/conservancy/summit_registration/models.py
@@ -0,0 +1,17 @@
+from django.db import models
+
+
+class SummitRegistration(models.Model):
+    """Form fields for summit registrants"""
+
+    name = models.CharField(max_length=300)
+    affiliation = models.CharField(max_length=700, blank=True)
+    address = models.TextField(blank=True)
+    email = models.EmailField(blank=True)
+    phone = models.CharField(max_length=100, blank=True)
+    date_created = models.DateField(auto_now_add=True)
+    cle_credit = models.BooleanField(default=True)
+
+    class Meta:
+        ordering = ('name',)
+