58th Meeting of the
September 29 -
Registration Form- KOS 2006 Fall
Meeting
Name
________________________________________________________________________
Address
________________________________________________________________________
City, State, Zip
________________________________________________________________________
Telphone ____________________
E-mail____________________________
Additional Persons Attending With You
___________________________________________
Registration Fee
$5.00 x ____=$______
Saturday Banquet
$12.00 x ___=$______
(Reservations may not be available after September
28)
Sunday Box Lunch $5.00 x
____=$______
(Subs & Chips)
Total Amount Due
$______
Brunch is available at the college dining hall
for about $4.00. I will probably
eat there. Yes___
No___
Pay at dining hall
Payment is
enclosed___________
I will pay at registration_________
(IF
MEALS ARE ORDERED AND YOU DO NOT CANCEL, YOU ARE LIABLE FOR THE COST! IF YOU PREPAY, MONEY CAN BE REFUNDED UP
TO SEPTEMBER 27)
Please mail completed registration to: Max C.
Thompson
Or you may register via e-mail to: maxt@cox.net
Make checks payable to Southwestern College
In submitting this
registration I (we) understand that
__________________________________________________
__________________________________________________
Signatures/Date