March 2, 2013 UICF “It’s Time" Unity Conference” Registration Form

Transcription

March 2, 2013 UICF “It’s Time" Unity Conference” Registration Form
Registration Form
March 2, 2013
UICF “It’s Time" Unity Conference”
Hosted by V. L. Childs/U.I.C.F.
Museum of Aviation GA HWY 247 Warner Robins, GA
10:00a.m. – 4:00 p.m.
go to www.vlchilds.com or call Vivian Childs (478) 953-9767
Full Name: _______________________________________________ (First name for badge)____________________________
Organization: ___________________________________________________________________________________
Preferred Mailing Address: __________________________________________________________________________________
City: ________________________________ State/Province: ______________________ Zip/Postal Code: _________________
Telephone: (______)______________ ___________________________
Fax: (______)________________________________
Email: __________________________________________________________________
CONFERENCE FEES
1. Registration Fees (All fees listed in U.S. Funds.)
PLEASE CHECK APPROPRIATE REGISTRATION FEE:
Individual (lunch included)
 $35.00 per person
$_________
Group (Indicate number of persons in Group) ______ X
 $35.00 per person
$ __________
Group Name__________________________________________________________

will receive 1 additional free paid registration)
registration form and indicate it is part of a group.
(Groups of ten, when registered together as a group,
Please have each individual in your group fill out the
2.
Cancellations/Changes and Refunds: Conference fees are non-refundable
3.
Payment:
TOTAL ENCLOSED:
$ __________
First 100 registrations will receive a special conference bag.
PAYMENT METHOD: Check or Money Order must be in U.S. funds payable to: VLCHILDS/UICF, LLC. There will be a $25.00 fee charged on
checks returned by the bank due to insufficient funds.
Please check appropriate box:  Check
 Prepaid  cash
Credit card processing can be made using the secure PayPal link on the Conference website www.vlchilds.com
Please mail completed registration form with payment to:
Phone: (478) 953-9767
Email: [email protected]
VLCHILDS/UICF, LLC 2006
PO Box 9334
Warner Robins, GA 31095
Do not email credit card information because security cannot be guaranteed. Please use the secure PayPal website for secure credit
card processing.