florida district convention registration form

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A FLORIDA DISTRICT ANNUAL CONVENTION SEPTEMBER 14—15, 2012 AGENDA Friday, September 14 3:00 p.m. District Board Meeting 7:00 p.m. Dessert Social/Trivia/Entertainment Saturday, September 15 7:15—9:00 a.m. Registration/Continental Breakfast 7:30 a.m. Council of Past Governors 7:30 a.m. President/President-Elect Forum 9:00 a.m. General Business Session 10:30 a.m. BREAK 10:45 a.m. General Business Session Noon Lunch with Speaker 1:00—2:30 p.m. Awards and Celebrations 3:00 p.m. 2012-2013 District Board Meeting 6:30 p.m. Social/Cash Bar 7:15 p.m. Dinner and Installation Banquet (After Five Attire) ________________________________________________________________________________________ HOTEL: Wyndham Orlando Resort, 8001 International Drive, Orlando, Florida Tel: 407 351-2420; 1-866-599-6674; www:wyndhamorlandoresort.com Rate: $79 plus tax. TO RECEIVE THIS RATE, RESERVE BY AUGUST 14, 2012 Ask for Civitan Annual Convention rate ________________________________________________________________________________________ _______________________________________________________________________________________ REGISTRATION FORM Registration $95 if received no later than August 30, 2012 ; After that $110 ________________________________________________________________________________________________ Member Name: ________________________________________________________________________________________________ Spouse/Guest: ________________________________________________________________________________________________ Street Address: ________________________________________________________________________________________________ City/State/ZIP ________________________________________________________________________________________________ Current Club/District Office Held: ________________________________________________________________________________________________ Have you attended a Florida District Meeting/Convention before? Y _____ N _____ E-mail address: ________________________________________________________________________________ Any dietary or other special needs? ________________________________________________________________________________________________ Registration: $95 per person X ____ = $ _________ After August 30, $110 X _____ = $ ______ Make checks payable to : FLORIDA DISTRICT CIVITAN Mail registration form and fees to: Gloria Poore, Registrar, 5353 Arlington Expy, No. 5A Jacksonville, FL 32211; Tel: 904 993-0111 E-mail: [email protected]

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September 14-1th District Convention Registration Form

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A

FLORIDA DISTRICT ANNUAL CONVENTION

SEPTEMBER 14—15, 2012

AGENDA

Friday, September 14 3:00 p.m. District Board Meeting 7:00 p.m. Dessert Social/Trivia/Entertainment Saturday, September 15 7:15—9:00 a.m. Registration/Continental Breakfast 7:30 a.m. Council of Past Governors 7:30 a.m. President/President-Elect Forum 9:00 a.m. General Business Session 10:30 a.m. BREAK 10:45 a.m. General Business Session Noon Lunch with Speaker 1:00—2:30 p.m. Awards and Celebrations 3:00 p.m. 2012-2013 District Board Meeting 6:30 p.m. Social/Cash Bar 7:15 p.m. Dinner and Installation Banquet (After Five Attire) ________________________________________________________________________________________ HOTEL: Wyndham Orlando Resort, 8001 International Drive, Orlando, Florida

Tel: 407 351-2420; 1-866-599-6674; www:wyndhamorlandoresort.com

Rate: $79 plus tax. TO RECEIVE THIS RATE, RESERVE BY AUGUST 14, 2012 Ask for Civitan Annual Convention rate ________________________________________________________________________________________ _______________________________________________________________________________________

REGISTRATION FORM Registration $95 if received no later than August 30, 2012 ; After that $110

________________________________________________________________________________________________ Member Name: ________________________________________________________________________________________________ Spouse/Guest: ________________________________________________________________________________________________ Street Address: ________________________________________________________________________________________________ City/State/ZIP ________________________________________________________________________________________________ Current Club/District Office Held: ________________________________________________________________________________________________ Have you attended a Florida District Meeting/Convention before? Y _____ N _____ E-mail address: ________________________________________________________________________________ Any dietary or other special needs? ________________________________________________________________________________________________ Registration: $95 per person X ____ = $ _________ After August 30, $110 X _____ = $ ______ Make checks payable to : FLORIDA DISTRICT CIVITAN Mail registration form and fees to: Gloria Poore, Registrar, 5353 Arlington Expy, No. 5A Jacksonville, FL 32211; Tel: 904 993-0111 E-mail: [email protected]