Registration and payment must be received no later than June 25, 2008.
NAME: ___________________________________________________________
ADDRESS: _________________________________________________________
STATE____________________ ZIP __________ PHONE (____) ______________
NUMBER ATTENDING IN PARTY: __________
REPUBLICAN WOMEN REGISTRATION: We invite you to become a member of a Utah Federation of Republican Women club near you. Conference attendees that sign up for membership in a Utah Federation of Republican Women affiliated club will be given a $20 discount off the combined registrations of the conference and the first year membership enrollment dues (first time members only).
CONFERENCE PRE-REGISTRATION -- $35 X (__ ) = ___________
(Registration at the door $45) # ATTENDING
UFRW AFFILIATED REPUBLICAN WOMEN CLUB (Optional)
ANNUAL DUES FEE (May vary by Club) -- $20 X (______)* + ___________
# OF NEW MEMBERS
SUBTOTAL = __________
NEW MEMBER DISCOUNT -$20 X (______)* - ___________
# OF NEW MEMBERS
GRAND TOTAL PAID FOR CONFERENCE = __________
Payment can be made by sending a check with this registration form to:
UFRW or on-line at paypal.com
c/o Darcy Kruitbosch Click on ‘Send Money’ tab,
PO Box 1562
