Rotary Club - Index
Rotary Club - Experience - Index
District 7330 District Conference – May 2-3, 2008
RegistRation FoRM
Please type or print & return to: Bill Blaney, PO Box 650, Perryopolis, PA 15473 Fax 724-677-4448
Your Family Name ________________________________ First Name_____________________________Middle Initial________
Badge/Call Name _________________________________ Club Name_____________________________________District 7330
GUEST INFORMATION
Guest Full Name ________________________________________Badge/Call Name_____________________________________
Children Name__________________________Age_____ Name__________________________Age_____
Name__________________________Age_____ Name__________________________Age_____
CORRESPONDENCE ADDRESS & TELEPHONE (include area codes)
Street___________________________________________City_______________________________State________Zip _________
Day (_____)__________________________ Evening (_____)________________________Fax (_____) _______________________
Email Address___________________________________Indicate Special Needs/Request _______________________________
ROTARY INFORMATION
__Club President __Club Secretary __Past Club President __Past District Governor __Major Donor
__Club President-Elect __Paul Harris Fellow __Benefactor __First Conference __New Rotarian
FRIDAY MORNING GOLF OUTING – $28 each, pay at course.
Please indicate number playing____________ x $28 Contact John Rusbosin @ 724-537-5115
email: johnr@rusbosinfurniture.com
DINING RESERVATION & REGISTRATION FEES
Friday Dinner Caribbean Buffet $37.50 X__________ = ___________
Saturday Prayer Breakfast Buffet $20.00 X__________ = ___________
Saturday Lunch 3rd World Luncheon $12.00 X__________ = ___________
Saturday Banquet File & Chicken $40.00 X__________ = ___________
Method of Payment
Total = ___________
_____Check _____Visa _____MasterCard Card Number________________________________
Signature___________________________________________ Exp. Date_________________________________
Nightly Room Charge: $99/night plus tax
Make Room Reservations with Mountaineer Casino, Racetrack & Resort
PO Box 358, Chester, WV 26062
for reservations, please call 1-800-804-0468
Please return this Conference Registration Form to Bill Blaney by April 4, 2008