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REGISTRATION & MEAL RESERVATIONS FOR GFWC VIRGINIA CONFERENCE 2016

1.  This form must be postmarked by July 22nd (Friday). After July 22nd LATE registration fee will be an additional $10.00

(a total conference package of $170.00 for late registration).

2.  Requests for meal refunds must be made by July 22nd in order to be considered. Registration fees are non-refundable.

3.  Please PRINT or TYPE all information and duplicate this form if more than six (6) members are to be registered.

4.  List highest CURRENT position (GFWC, state, district or club) held by each person registered.

5.  Check appropriate meal boxes for each member registered; after reviewing menus please explain any dietary restrictions for specific members.

6.  Be sure to check appropriate box for members attending their FIRST state meeting as “first time attendee.”

8. Make ALL checks payable to GFWC Virginia. Generals send checks/forms to Linda Holsclaw; Juniors send checks/forms to Cheryl Wilson

NAME of MEMBER

CURRENT POSITION

Saturday

Box Lunch

$15

Sat / Sun Conference Package $160

Yearbook $10.00

First

Time
Attendee?

PayPal fee

$4.00

See instructions on next page

TOTALS:

Amt. of Check:

Amt. of PayPal:

#

$

#

$

#

$

#

#

$

Club Name:

District:

Check One: o General o Junior o Juniorette

Form Submitted by:

Phone Number:

 

Address:

 

General Clubs Mail To: Linda Holsclaw Junior Clubs Mail To: Cheryl Wilson

10202 Delray Court and 304 Front Ave.

Glen Allen, VA 23060 Juniorette Clubs Salem, VA 24153

Phone: 804/672-3822 Phone: 540/375-3926(H)

e-mail: *****@***org e-mail: *****@***org

SPECIAL DIET ~ Please indicate any special food needs for member(s): NAME:

FOOD ALLERGIES:

VEGETARIAN MEAL:

DIABETIC:

Instructions for making electronic payment for Convention

Using your PayPal account, follow these steps:

Send & request money

Pay for goods & service

Enter *****@***org

Click next

Enter amount - please add $4 to your registration & meals total to cover the PayPal fee.

Click continue

Click send money now

Save the registration form to your computer and complete all the necessary information.

Save the updated file and then email your registration form to:

*****@***org AND Generals - *****@***org Juniors & Juniorettes: *****@***org