The 56th Annual Indiana District Key Club Convention - March 28-30, 2008
CONVENTION REGISTRATION FORM
Please key all information in upper and lower case (ex. John Smith):
Name of Division Name of Club Type of Club (Kiwanis, Circle K, Key Club, Builders, Aktion, K-Kids) Chaperone Name registered adult (Responsibility to chaperone group at the convention) First Name Last Name Name of Contact (Person to receive reg confirmations / questions from TMC) First Name Last Name Mailing Address City State Zip Code Daytime Phone Email Address Please enter all values. No. of Registrants in Quads = x $250.00 = $ No. of Registrants in Triples = x $260.00 = $ No. of Registrants in Doubles = x $280.00 = $ No. of Registrants in Singles = x $335.00 = $ No. of Registrants LATE FEE = x $25.00 = $ TOTAL AMOUNT = $
(Kiwanis, Circle K,
Key Club, Builders,
Aktion, K-Kids)
Chaperone Name
registered adult
(Responsibility
to chaperone group
at the convention)
Last Name
Name of Contact
(Person to receive
reg confirmations /
questions from TMC)
First Name
Please enter all values.
Please submit check or purchase order for the total amount payable to:
"The Meeting Connection, Inc."
893 High Street, Suite J
Worthington, OH 43085
*Please enter chaperone name from above also into the rooming list below.
Room
(To be printed on badge)
Name of
Key Club
Office Held
(as of 10/01/07)
Gender
Vegetarian or
Handicap
Type (Quad, Triple, etc.)
Student / Adult
1
M F
Neither Vegetarian Handicap
Q
T
D
S
S A
2
3
4
5
6
