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Registration Form
Pacific Southwest District
LWML Convention
June 6-8. 2008
Alexis Park Resort--Las Vegas, Nevada
Registration Deadline: May 6, 2008 
No Refunds After: May 31, 2008

Each person must register.  Only one (1) registrant per form.  This form my be copies.  Please type or print clearly.  Make a copy of completed form for your records.

Circle One:  Mr.     Mrs.     Rev.     Miss     Young Women Rep.    Exhibitor     Spouse     Teen LWML     Heart to Heart Sister 

Last Name _________________________________ First Name__________________________

Street Address_________________________________________________________________

City __________________________State ______ Zip ____________ Phone(___)___________

E-mail __________________________________ FAX Number (___)______________________

Emergency Contact _________________________________Phone Number(___)__________

Church ___________________________________________ City, State __________________

Special Requirements (please describe any handicaps or dietary needs)_________________

___________________________________________________________________________________________________

 

1

Registration fee (packet and general expenses)

$60.00

$

1

Spouse/Teen LWML registration fee

$35.00

$

1

Exhibitor registration fee (includes one table and badge)

$90.00

$

1

Late fee (after May 6, 2008)

$75.00

$

1

Friday Evening Dinner

$26.00

$

1

Saturday Breakfast Buffet

$13.95

$

1

Saturday Lunch

$17.50

$

1

Saturday Banquet (Includes Entertainment)

$35.00

$

1

Sunday Breakfast Buffet

$13.95

$

1

Sunday Lunch

$17.50

$

Qty

District Charm ____ District Pin ____

$4.00 x ___

$

Qty.

Mission Walk T-Shirt: Sm.___ Med.___ Lg.___ XL___

$10.00 x ___

$

Qty.

Mission Walk T-shirt  2X___ 3X___ $12.00 x___ $

 

Donations

 

$

 

TOTAL

 

$

Complete this form. Mail form and check to:

Barbara Paetzel
PO Box 751562, Las Vegas, NV  89136
Questions?  Call 702-655-0915

REGISTRATION DEADLINE: MAY 6, 2008 NO REFUNDS AFTER: MAY 31, 2008

  Please make check payable to LWML Pacific Southwest District 
Check No. _________ Date _________

   Complete Interest Session form also.