2011
Please complete the form below and check applicable
conference information so we are aware of your needs.
Mail or email forms to
OCB Treasurer Julie Bailey at 19425 E. 48th St.,
Name
____________________________________________
Address__________________________________________
City_______________
State__________ Zip____________
Work Phone ( )___________________________________
Home Phone
__)___________________________________
E-Mail
____________________________________________
____ Full Registration(includes four
meals)…..…...…$80.00
____ One Day Registration
(includes 2 meals).……...$50.00
____ Extra Lunch Ticket (for those Not already
registered either as Full or One
Day…………….$20.00
____ Extra Banquet Ticket (for those Not
already
Registered either
as Full or One Day……………$25.00
____ I need a vegetarian meal at the banquet.
____ I need an assistive listening device.
I need my program in
____ Large Print ____
Braille
Other Special Needs________________________________
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.