CHOSEN HEADQUARTERS HOTEL |
Mail registrations to: |
Address |
Interim Board Chair [ Name ] |
Midstate, TN 00000 |
Address |
Telephone 615-555-5555 |
City, TN 00000 |
Phone: 615 / 555-0000 | |
I AM REGISTERING AS: | |||||
I am a first-timer to a BPW / TN Interim Board ____ |
Voting: |
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____ State Officer | |||||
Please check the functions you plan to attend: |
____ Regional Director |
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____ District Director |
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Before 00 / 00 / 99 |
After 00 / 00 / 99 |
____ Standing Committee Chair ____ Immed. Past State President |
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Registration Fee |
$ 00.00 |
_____ |
$ 00.00 |
____ |
____ LO President / Representative ____ Bylaws Chair |
Saturday Lunch |
$ 00.00 |
_____ |
$ 00.00 |
____ |
Non-Voting: ____ Parliamentarian |
Total |
$___________ |
$___________ |
____ Special Committee Chair ____ Past State President |
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State Officers, Regional Directors, Standing Committee Chairs, |
____ Member [ MOL or SOL ] |
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Parliamentarian, Immediate Past State President |
____ Member at Large |
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SEND CHECK FOR NON-EXEMPT EVENTS ONLY |
___ Guest |
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