2010 Fall Region Meeting
October 5th - 20th, 2010    

 

                  

Corporation:    Telephone: Region:  

E-mail address of person completing form:   P.O. Number  

          

                                   Please Print or Type

Name of registrant


                                                         		 

$27.00

 

  

 

  

Total
$$
Name Title              
         
         
         
         
           
           
           
                   

                                    

     Bill my corporation  Check Enclosed Total Amount Due: $     P.O. Number:  

                     

Cancellation Policy:  Cancellation requests must be submitted by email to Linda Strauss, lstrauss@isba-ind.org  at least 5 days before the meeting to avoid the registrants being charged.  Cancellations will be confirmed by a return reply.  After that date, no refund of registration fees is granted; however, substitutions and name changes may be made.