WYRID Fall 2005 Workshop

Registration Form    

Please send your pre-registration form (the bottom of this form) and check by Sep 8, 2005

            To: Kathy Andrews 5 Hilltop Lane , Sheridan , WY 82801 , kandrews@fiberpipe.net

 

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Name: ____________________________________________________________________

 

 

Phone No:  ________________________

 

E-mail: ____________________________________________

 

Address:___________________________________________________________________

 

WYRID Member?  _____Yes _____ No

 

AMOUNT ENCLOSED:  ___________________ CHECK # ________________

 

If needed I will interpret: SATURDAY:  Yes ___ No ___  SUNDAY: Yes ___ No ___

 

Specific Accommodations (if any): 

 

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