
2009
Please
complete the form below and check applicable conference information so we are
aware of your needs
Name
____________________________________________
Address__________________________________________
City_______________
State__________ Zip____________
Work
Phone (
)___________________________________
Home
Phone __)___________________________________
E-Mail
____________________________________________
____
Registration $
80.00
____
Extra Lunch Ticket
(applies to
people with friends and family already
registered at the Convention. $ 20.00
____
Extra Banquet Ticket
(applies to people with friends and
family already registered at the Convention) $
30.00
____
I need a vegetarian meal at the banquet.
I
need my program in
____
Large Print ____ Braille ____ Disk
Other
Special Needs________________________________
Please send your
registration form and payment to:
For
more information, contact: Vicky
Golightly
Convention
Chairman, Home Phone: (405) 524-6227,
Work Phone: (405) 522-0526 or via e-mail
at vgolight@yahoo.com.