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| [print out page] |
| Fee: $450.00 |
| Deposit: $50 non-refundable, applied to fee Please register before November 10, 2008 |
| Amount enclosed: _____________ |
| Location: | _____________________________ |
| Dates: | _____________________________ |
| Director: | |
| First Choice: | _____________________________ |
| Second Choice: | _____________________________ |
| Third Choice: | _____________________________ |
| Name: | _____________________________ |
| Address: | _____________________________ |
| _____________________________ | |
| Zip: | ___________ |
| Phone: | _____________________________ |
| Email: | _____________________________ |
Mail registration and check
(payable to Weber Retreat and Conference Center) to:
Please mail this form and deposit directly to
Weber Retreat and Conference Center
1257 E. Siena Heights Drive, Adrian, MI
49221