I WANT TO JOIN
R.I. PRESIDENT 2007-08
WILF WILKINSON
in
"Sharing the Magic of Rotary"
July 13-14, 2007
Villanova University, Villanova, Pennsylvania
CONFERENCE REGISTRATION FORM
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Registration Fee ONLY $85 Registration Deadline July 2ndwhich includes:
On Site Housing Available in Villanova University Campus Apartments at very reasonable rates
A Separate Housing Request Form must be completed |
[PRINT OUT FORM AND FAX OR MAIL TO ADDRESS BELOW]
____________________________________________________ Rotarians Name _________________________________ ____________________ Badge Name District ______________________________________________________ Club Name ______________________________________________________ Current Rotary Club or District Office ______________________________________________________ Mailing Address ______________________________________________________ City, State and ZIP __________________________________ _____________________________ Preferred Telephone Number FAX Number ______________________________________________________ E-Mail Address
PAYMENT BY CHECK, MASTER CARD OR VISA ______________________________________ ________________ Credit Card Number Exp. Date _______________________________________________________ Exact Name on Card _______________________________________________________ Credit Card Billing Address ________________________________________________________ City State ZIP ________________________________________________________ SIGNATURE (Required) |
COMPLETED REGISTRATION FORMS MAY BE FAXED OR MAILED (CHECKS MUST BE PAYABLE TO "ROTARY INTERNATIONAL, ZONES 31/32" AND MAILED) TO: PDG Dan Spencer, 404 North Brown Street, Gloucester City, New Jersey 08030 Telephone: 856-374-6310 FAX 1-856-374-6374 E-Mail: dans@camdencounty.com