PERSONAL INFORMATION

Name:		

E-mail Address:	

Address: 		

City: 		

State:		Zip:

Phone Number:	

EVENT INFORMATION

1. How many people are you expecting?:

2. How many hotel rooms will you be using?:

3. What is the date of your convention/meeting or reunion?:

4. What is the age group of the participants?:20-3030-4040-5050-60Over 60

5. Do you need help in planning your convention/meeting or reunion?  YES NO (If NO, go to question 11)

8. Do you need help contacting and securing space with hotels: YES NO

9. Do you need help with spouse tours? YES NO

10. Do you need activities at night? YES NO

11. Would you like a packet of info sent to you to assist in your planning?

YES NO

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