Conference Registration Form: Please Print or type in the case of email
Name: __________________________________________________________________ Address: ________________________________________________________________ City: _______________________________________State: ______ Zip: _____________ Home Ph.: ________________ Work Ph: _______________ Cell: Ph: _____________________________________________________________________ Club:___________________________________________________ District # _________ Club Officer or Position, if applicable: _________________________________________________________________________ Occupation*(Required for accounting purposes)___________________________________________
_________ Check here if you will volunteer for an hour & indicate preference below
_________ Decorating _________ Greeter or Hostess
_________ Check-in _________ Official position ie: time keeper or sergeant-at-arms
PLEASE, let us know if you have any special dietary needs or restrictions or if you require any other special needs such as handicapped services:______________________________________
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