CCCFLC Annual Conference Registration 2011

2011 CCCFLC Annual Conference Registration
CC & CCSF

____ Friday, October 14: Orange Coast College, Costa Mesa

____ Friday, October 21: City College of San Francisco

Cost: $35 for full-timers, $30 for part-timers

____

Vegetarian Lunch

____

Non-Vegetarian Lunch

Morning coffee is also included

	Name:____________________________________________________
	College Address:____________________________________________
	City:______________________ State:______ ZIP:______________
	Home Address:_____________________________________________
	City:______________________ State:______ ZIP:______________
	To which address should we send your receipt? ___ home ___ college
	Which address do you wish us to use on the attendance list? ___ home ___ college
	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)

Please be sure to check which meeting you plan to attend above!!!

Please print, complete, and return by September 30 to:
Tom Blair, 424 El Dorado Terrace, San Francisco, CA 94112-1753
Thanks!

A receipt and campus information will be mailed to you.