WSAD WEBSITE

Washington State Association

of the Deaf

Established 1909 / Incorporated 1913

WSAD 2007 Conference

To print: Click here for Word Doc
or you can copy and paste below.

NEW! Click here to pay by credit card!

1. Participant Information Please print—Limit two registrants.
(1)First\Last Name ____________________________________________	(2) First\Last Name ___________________________________________
Email (Required if you have one.) ____________________________________________	Email (Required if you have one.) ___________________________________________
Address:_____________________________________	City:_______________________________________
State/Province Zip_________________________________________	Telephone:_______________________ TTY \| VP \| V

2. Registration Information

Individual Fees
Registration Fee (required—non-refundable)	$15.00 X ______= $ _______
Friday Night Reception	$25.00 X ______= $ _______
Saturday Lunch (not available after 5/24)	$35.00 X______ = $ _______
Saturday Banquet (not available after 5/24)	$50.00 X ______= $ _______
Entertainment (after banquet)	$25.00 X ______= $_______
Banquet Menu _____ Chicken _____Salmon _____Vegetarian write number for the following entrée (s)
Childcare Fees for children under age 12
Childcare during WSAD events
More info contact Julia Petersen: childcare@wsad.org
	Total Amount Paid: $___________


3. Method of Payment (Payment must accompany registration or the form will be returned to you.)Check or money order payable to 2007 WSAD Conference Mail to: 2007 WSAD Conference, 4626 Celia Way #202, Bellingham, WA 98226 No Personal Checks Accepted After May 24, 2007 or Paypal using your credit card online.
Questions? Registration Chair Tamara Frijmersum: registration@wsad.org
Office Use ONLY: Date Rec’d_________ Amount Rec’d____________ Deposit Date_________________