your image 1 here; set for 100 x 100 District
Spring Conference
Holiday Inn
Your Town, State
May 18 - 20, 2001
Registration Form
your image 2 here; set for 100 x 100

Mr ___ Mrs ___ Ms ___ Name: ________________________________________

Address: _______________________________ Phone: ____________________

City: ____________________ State: ___ Zip: ______ Club: ____________

E-Mail: ____________________________________________________________

Club Office Held: ______________________ Your First Conference? ____

Last day for meal registration is May 1 lth. NO meal orders will be taken at the conference. NO refunds after May 11th. Rooms are blocked until May 4th -- no guarantee of availability after that date, however, the hotel will honor our reduced rates after May 4th if space is available. At hotel check-in identify your group name as Your Group for the reduced rates.

EVENT PRICE QTY TOTAL
Early Registration (received by May 4) $16___ $______
Husband and Wife Members (received by May 4) $21___ $______
Guest Registration (credited to meal purchase) $ 5___ $______
Award Luncheon $15___ $______
Contest and Banquet $23___ $______
Late Registration (received after May 4) $19___ $______
Husband and Wife Members (after May 4) $25___ $______
Sunday Breakfast (Roast) $11___ $______
TOTAL FOR ALL EVENTS $______

Make checks payable to Your Event, then mail the form and check to:

Contact 1
Street Address
City, State Zip
Registration questions? My phone
Other conference questions? Contact 2
E-mail@here.com

Check must accompany registration. NO meal orders will be taken at the conference. Registration is required for all meal events; Contestants do not pay a registration fee, but they must register and pay for meals eaten.