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Air Care 2005 Form

       

 

AIR CARE 2005 Conference Registration Form
(See Conference Information Page for Housing/Meal Registration)

Please Register the Following Persons to attend AIR CARE 2005 April 29 - 30:
PRINT NAME (as desired on name tag)   Attend Conference?    Friday Dinner?  Saturday Night Dinner (circle y or n) 

1)                                                                             Y   N                     Y   N                  Y   N

2)                                                                             Y   N                     Y   N                  Y   N

3)                                                                             Y   N                     Y   N                  Y   N

4)                                                                             Y   N                     Y   N                  Y   N

5)                                                                             Y   N                     Y   N                  Y   N
      (for additional persons continue the list on another page

Form completed by: __________________________________________

Phone Number__________________________  Group__________________________

Email address_________________________________

Fee for 1st attendee from your group.-  $ 35                 $ 35  first attendee
plus special registration rate for additional
people attending from the same group:  
   ______ additional attendees  x $20          plus    $ ________ additional attendees

        TOTAL submitted:                                       = $ ________

Number attending Friday dinner  ______    (No extra charge for meals included in lodging fees)

Number attending Saturday dinner  ______   (No extra charge for meals included in lodging fees)

Note: for those staying elsewhere we will charge a meal cost for those eating in the dining room, collected on site. 
Here are the meal charges: Breakfast: $7.00 Lunch: $8.50 Dinner $12.50 2 & under No Charge

NOTE: Payment by check is preferred and can be mailed to us or brought with you to the conference.  

Circle one:     Check has been mailed in      or     Will Bring Check to Conference               

Signed ________________________________________________________

FAX COMPLETED FORM TO: 603-806-7937 BY  Fax deadline   April 27, 2005
               Or MAIL TO ADDRESS BELOW BY        Mail Deadline    April 18, 2005

NOTE - 4-13-05: the conference is filling rapidly. If it fills to capacity we may have to terminate registrations.  Please register as soon as possible to assure your seat.  It would be best to FAX your registration form.

AIR CARE 2005 Registrar
c/o
Angel Flight of Georgia
2000 Airport Road  Suite 227
Atlanta, GA 30341    

AFTER THOSE DATES call us at (770) 452-7958 ext 3, fax us at 603-806-7937 , or 
email us at
mailto:angeladmin@aol.com for late registration and on-site registration information.

4-12-05 LATE BREAKING NEWS: THIS CONFERENCE IS ALMOST SOLD OUT. DO NOT DELAY
WE MAY HAVE TO DENY OR CANCEL REGISTRATIONS IF WE RUN OUT OF ROOM.

This is for the conference registration; also see the 
Conference Information Page
for Housing/Meal Registration


Questions? Send them to conference@aircareall.org

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