District Conference 2010 Registration

Register Form

Conference Registration Fullname:
Gender:
Date of Birth:
Name of Rotaract Club:

Conference Room Type

Areas of training for PETS:

Additional Nights stay Sunday June 6 to Monday June 7 (US$110.00)

Sunday Bus trip only (US$10.00)

Pre-Conference
Address:
City:
State/Province/Parish:
Postal Code:
Country:
Email Address:
Home Phone No.:
Work Phone No.:
Mobile Phone No.:
Fax Phone No.:
Any medical/dietary or other information we should know?:
Are you bringing a guest/Child/Children?: Yes

Security Code

District Conference 2010 Registration

Register Form

Conference 2010 Sponsors

General Rotary/Rotaract

District 7020 Rotaract Clubs

Rotaract Supplies

District Document Library