REGISTRATION

Annual Rotary Bi-District Conference
Districts 5520-4110

Santa Fe, New Mexico, November 8th – 9th, 2002

1) Fill the following form and

2) Click the SUBMIT button at the bottom for preregistration and fast processing.

3) Print the form and send it along with your check to:

Because of exchange rate complications, US Rotarians only may pay by check

Rotary District #5520; C/O Michelle Coons;

Wells Fargo Bank; 150 Washington; Santa Fe, NM 87501

or

Fax this form to 1 505 984 0410 (Updated 11/4/2002)


Questions regarding your registration form may be directed to

Caroline Adams at 1 (505) 984-8500.

 

1) Fill out the form

Personal Information

Name
Club
District
Classification
Preferred Badge Name
Address
City
State
Zip
Phone
Business
Home
Fax
E-mail
Spouse Name

Activities Registration

Friday, November 8th
Indicate Attendance #
Ice Breaker/Buffet at Eldorado Hotel
(Included with registration)
Booths will be available for viewing Matching Grants

Saturday, November 9th
 
Lunch at Eldorado
(Included with registration)

Home Hospitality
(Santa Fe Private Residences)

Registration Fee: $75.00 US (per person)

Registration fee includes all items listed above:Ice Breaker/Dinner Buffet at The Eldorado Hotel, Snack Breaks, Lunch and Home Hospitalities.
Indicate Attendance #
$75.00 USD x

TOTAL

Type of card

Visa
Mastercard
American Express
Card Number

Name & Expiration date

Month
Year
Name on the card

 

2) E. MAIL OR FAX COPY OF THIS FORM AT: 1 505 984 0410 (Updated 11/4/2002)

3) Print the form and send it along with your check to:
Because of exchange rate complications, US Rotarians only may pay by check
Rotary District #5520; C/O Michelle Coons;

Wells Fargo Bank; 150 Washington; Santa Fe, NM 87501

.
Questions regarding your registration form may be directed to

Caroline Adams at (505) 984-8500.

 

 

 

Copyright © 2001 - 2002. Hermay NM. All Rights Reserved.