 |
| ||||||||||
|
|||||||||||
2011 Seminar Registration Form
PLEASE PRINT CLEARLY
| Name(s): | ______________________________________________________________________ | |
| ______________________________________________________________________ | ||
| ______________________________________________________________________ | ||
| Telephone Number: | ______________________________________________________________________ | |
| Email Address: | ______________________________________________________________________ | |
| _______________ | Members at $42.00 (includes lunch) | ______________________________ |
| _______________ | Non-Members at $47.00 (includes lunch) | ______________________________ |
| Total enclosed: | ______________________________ | |
Persons paying after 5 February 2011 or at the door will be charged $50.00
(includes lunch).
Registrations must be received by February 5th for the
advanced price. Requests for refunds will be honored thru February 5th.
Please print this page and mail with your check payable to Pinellas Genealogy Society to:
Beth Shields, PGS Seminar Registration
11660 68th Ave
Seminole, FL 33772
Confirmation of registration will be delivered by email or an enclosed SASE.
| Name: | __________________________________________________ |
| Select one | |
| __________ | Turkey with Swiss cheese on whole wheat |
| __________ | Ham with cheddar cheese on whole wheat |