LLC 2000 |
Registration |
Name: ________________________________________________________
Badge Name: ___________________________________________________
Address: ______________________________________________________
______________________________________________________
City: _________________________ State: ___________Zip:_____________
Phone: (_____)_________________ email: ___________________________
Postmark Date |
Registration Rate |
| Before December 31, 1999 | $60 |
| January 1, 2000 until the event | $75 |
| Quantity | Price | Total | |
| Full Registration | $60/$75 | ||
| T-Shirts | $15 | ||
| Circle size (S, M, L, XL, 2X, 3X, 4X) | |||
| Total |
| Note: | Make checks and money orders payable
to "LLC2000" Mail registration must be postmarked by March 15th. There is a $10 cancellation fee. No refunds will be granted after March 30, 2000. |
___ I would like to volunteer. |
___ Send me/my organization ___ brochures. |
| ___ I need ASL services. | ___ Send me a presentation proposal guide. |
Club Affiliation: _____________________________________________
Mail To: |
LLC2000 P.O. Box 91997 Washington, DC 20090-1997 |