Name: *

Chapter: *

Position:

Street, City, Zip: *

Email Address: *

Telephone Number:

Attend Presidents Meeting? (1:00 to 5:00 pm Friday): *

Yes No

Attend Friday Hospitality Suite? (5:30 to 9:00 pm): *

Yes No

Attend Saturday Educational Events?: *

Yes No

Attend Saturday Lunch?
(12:00 to 1:00 pm): *

Yes No

Attend Sat. Night Event? (TBA): *

Yes No

If attending Sat. Night Event - number in your party: *

Comments: