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You are here Home ~ serraUSA >> serraUSA "In the Loop" >> serraUSA Planning Conference >> serraUSA Planning Conference Registration

District Governor and Regional Director

Planning Conference

Registration

Instructions

This form may be used to register for the USA Council of District Governor Planning and Training Conference. Please complete this online registration form including your address and personal contact information particularly your phone, fax number, and email so that we can confirm your registration via telephone, the USA Council will contact you once we receive the completed  registration.

Do not include your credit card number anywhere on this form.

Please provide all possible contact information, so our meeting registrations will be complete.

When you are finished filling in the form, click the Submit Form button.

Please register by December 15, 2010 for the District Governor Planning and Training Conference - Super Weekend.

The weekend begins promptly at 7:30 AM and the USA Council invites you to stay for Super Weekend which ends promptly at 12 Noon Sunday. Please plan accordingly as you make your travel arrangements. Thank you.

Yes, I would like to register for District Governor Training!
Yes, I WILL need a room for the weekend. (Please complete both the meeting and hotel reservation sections.)
No, I WILL NOT need a room for the weekend. (Please complete the meeting registration section only.)
Serra Club of

Region

District

Meeting Registration
Name:
Address 1:
Address 2:
City:
State: Two-character US State
Zip Code:
Home Phone: include area code
Work Phone: include area code
Cell Phone: include area code
Email:

Name Tag1:

Position:

Spouse Name, if attending

Name Tag2:

  I will attend the optional dinner on Thursday, January 13 2011.
Fees: Registration Fee:
Hotel Reservation
The room rate is TBD. Because there are a limited number of rooms available for the conference please complete your registration form in December 15, 2010. The hotel has also requested that all rooms be guaranteed with a credit card number, therefore the USA Council Office will contact to confirm your hotel reservations.
Type of room: King size Non-Smoking Room
Double/double Smoking Room
Arrival: Day: Time:
Departure: Day:(Checkout time is 12:00 PM)
Rooming with: Name:
Special Instructions:

 

Please enter security code: 1222

 


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