CCCFLC Annual Conference Registration 2004

2004 CCCFLC Annual Conference Registration
Riverside & San Francisco

October 15: Riverside College, 9:30AM - 3:00PM

October 22: City College of San Francisco, 9:30AM - 3:30PM

4th and Mission, Downtown Center, 8th floor

____	Riverside College Meeting, Oct. 15
____	San Francisco Meeting, Oct. 22

Cost: $30 for full-time, $25 for part-time; $15 extra for non-members

____

Vegetarian Lunch

____

Non-Vegetarian Lunch

	Name:____________________________________________________
	College Address:____________________________________________
	City:______________________ State:_______ ZIP:_______________
	Home Address:_____________________________________________
	City:______________________ State:_______ ZIP:_______________
	Which address do you wish us to use on the attendance list? ___ home ___ school
	College Tel. (___)____________ E-Mail:_________________________
	College:____________________ Lang(s):________________________

Your Payment (check as applicable):

Registration:

____

Part-Time

____

Full-Time

Total Enclosed: $_______ (please make check payable to CCCFLC)

Deadline for Registration: Sept. 30, 2004

Please print, complete, and return to Tom Blair, 424 El Dorado Terrace, San Francisco, CA 94112-1753. Thanks!