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2004 CCCFLC Annual
Conference Registration
Riverside & San Francisco
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|
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| October
14: Fullerton College, 9:30AM - 3:00PM |
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| Cost:
$30 for full-time, $30 for part-time; $15 extra for non-members |
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| ____
| Vegetarian
Lunch | | ____ | Non-Vegetarian
Lunch | |
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| Name:____________________________________________________
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| 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):________________________ | |
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| Your
Payment (check as applicable): |
| Registration: | |
____ | Part-Time |
| ____ | Full-Time |
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Total
Enclosed: $_______ (please make check payable to CCCFLC) |
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| Deadline
for Registration: Sept. 15, 2005 |
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| Please
print, complete, and return to:
Tom Blair, 424 El Dorado Terrace, San Francisco,
CA 94112-1753
Thanks! | |
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A
receipt and campus information will be mailed to you. |
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