| The Registration
Form is also available as a Microsoft Word file
which you can download, fill in on your computer, print,
and mail.
"Shape up your organization and empower
the community."
Date and time:
May 16, 2006
7:00 a.m. - 3:30 p.m.
Location:
Lionsgate
Center
1055 South Highway 287
Lafayette, CO 80026
YES! I want to attend.
Please submit a separate form for each registrant.
Photocopy if necessary.
Name _________________________________________________
Organization
_________________________________________________
Title _________________________________________________
| Mailing Address: |
Home _____ |
Business: _____ |
________________________________________________
________________________________________________
City _________________________________________________
State _____ Zip ______________
Phone (H) ________________
(Bus.) ___________________
Fax _____________________________________
E-mail ___________________________________
Payment Type:
Check _____ Visa
or Mastercard _____
Visa or Master Card # _______________________________________________
Expiration Date _____/______
Billing Zip _____________
Signature _____________________________________
Registration * (check one please):
___ $30.00 Board and Staff Breakfast
Only
___ $60.00 Workshops and Lunch (not
including Board
Breakfast)
___ $75.00 Full Day (Breakfast, Workshops,
Lunch)
___ $30.00 Lunch Only
*Team Discount: Organizations
with five or more members attending the full conference
will receive a 20% discount on their fees. To ensure
receipt of discount all registrants must be sent in
at one time.
Amount Enclosed: $ ___________
Limited space is available for this event.
Registration will be accepted on a first paid basis;
pre-registration and ends Wednesday, May 10, 2006. Registration
on the day of the event is per availability, and there
will be an additional fee of $10 per registration.
Please make checks payable to The
Community Foundation.
Send payment enclosed with this form to:
The Community Foundation
1123 Spruce St.
Boulder, CO 80302
or
Fax to: 303-442-1221
For more information, please call The Community
Foundation,
303-442-0436 • Toll Free: 1-877-744-7239
|
