2010 Oklahoma Council of the Blind Convention Registration Form

Please complete the form below and check applicable conference information so we are aware of your needs. Mail forms and checks to: Oklahoma Council of the Blind, 19425 E. 48th St., Broken Arrow, OK 74014.

The Convention will be held on September 24th-26th at the Doubletree at Warren Place, 6110 S. Yale Ave. in Tulsa. Sleeping rooms are $82 plus tax for up to 4 guests per room. Call (918) 495-1000 to make reservations.

Name_____________________________________

Address ___________________________________

City _______________ State ______Zip _________

Home Phone (___)___________________________

E-Mail _____________________________________

_______ Pre-registration by September 21st

(entire conference)........ $80.00

_______Registration after September 21st

(entire conference)........ $90.00

_______Registration for students

(includes Fri and Sat activities and Sat lunch)....... $35.00

_______One day Registration

(Saturday, Includes Saturday lunch and banquet) ............... $65.00

_______Extra Banquet Ticket........... $30.00

_______Lunch only ......... $25.00

_______Yes I will be attending the Friday night Hay Ride activity

_______I need a vegetarian meal at the banquet.

I need my program in

____ Large Print ____ Braille ____ Computer Disk

Other Special Needs

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