AAUW Convention Registration Form

CONVENTION REGISTRATION

Name:	Branch:
(As you would like it to appear on your badge)
Street Address:	Apt. #:
City:	State:		Zip:

Email:	Phone:	Fax:

VOTING STATUS (Check one only)

Member

Past State President

Delegate

Alternate Delegate

Branch President/State Board Member Branch

C/U Representative

State Board Member

(Name of College/University)

(Position)

SPECIAL DESIGNATIONS (check all that apply)

50-Year Member

First Timer

Student Affiliate

Guest

MAL

WORKSHOPS (mark 1st and 2nd choices)

Making A Difference By:


			International Relations
			Public Policy
			21^st Century Recognition Program

SPECIAL NEEDS (dietary, access, etc)

DISPLAY SPACE

Board members of AAUW of NC and Branch Educational Foundation Chairs should contact Mildred Hoffler-Foushee to reserve display space.

FEES

	Amount	Quantity	Total
REGISTRATION
Postmarked by Feb 13	$30.00
Postmarked After Feb 13 Late Fee	5.00
MEALS
Saturday Luncheon	17.00
Saturday Banquet	27.00
Dinner Theatre ( Friday night)	35.00
AAUW NC History Booklet	15.00
TOTAL PAYMENT ENCLOSED
Payment Method:	(see note below)
	Credit Card payment Online
	Check Number # (payable to AAUW –NC)

RETURN BY Feb 13	For AAUW Use Only
Mildred Hoffler-Foushee	Postmarked _____________
6005 Starboard Drive	Amt. Rec’d _____________
Greensboro, NC 27410	Check No. _____________

Note: If registering by Fax or Mail, check must match number submitted and be postmarked by Feb 13^th.

Contact: aauwnc@rtpnet.org
Last updated 07-Dec-2001
Back to AAUW NC 2002 Convention