| Name, Title | ___________________________________________________________________________ | ||||
| Agency | ___________________________________________________________________________ | ||||
| Address | ___________________________________________________________________________ | ||||
| City | ________________ | State | ____ | Zip | __________ |
| Telephone | (_____)______________ | _____________________ | |||
*Payment enclosed for (please check amount): ___ $120 (must be received by 1/11/08) OR ___$150 (if received after 1/11/08)
I will attend (please check in front of city): ___ SACRAMENTO ___ OAKLAND ___ LOS ANGELES ___ SAN DIEGO
For vegetarian meal, specify: ___ YES or ___ NO
Other Comments: __________________
*Purchase orders, checks and money orders accepted. Please return registration forms for each attendee with payment to:
On the Capitol Doorstep; 717 K Street #304; Sacramento, CA 95814. Also send an email to otcd** with names of attendees so that we can confirm receipt. Phone: (916) 442-5431; fax: (916) 442-1035.
Make checks payable to: On the Capitol Doorstep.
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**All email addresses end @otcdkids.com
This page last updated 8/27/07.