March 1-3, 2002

Official Registration Form

Registration

Fee: $130 per Circle K member for two nights accommodations, three meals, and admittance to all Circle K events. This fee does not include incidentals.

Deadline: All registration forms MUST be postmarked by Monday, February 11.

Include: Payment (NO CASH), health form, and this registration form.

Checks: Make checks payable to: New England District of Circle K.

Mail to: Erin Rowe

1515 Woodward Hall

Bridgewater, MA 02325

Late Fee: ALL late registrants are subject to a $20 late charge.

Note: No Refunds after February 14, 2002.

Substitutions: Must be approved by Erin Rowe (508) 531-7169 (VM #5462).

Registrant Information

Name____________________________________________ (as desired on the nametag.)

School _________________________________________________________________

Address ________________________________________________________________

________________________________________________________________

Email _________________@_______________ Phone # (___) ______ - ____________

Office Held_______________________________

Preferred Roommates

____________________________ from _________________ Circle K

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I plan on arriving Friday, March 1, 2002 and will be staying through Sunday, March 1, 2002. I understand my $130 registration fee includes two night quad lodging, three meals, and admittance to convention activities. I also understand that my fee is non-refundable after February 14, 2002.

Signed: _________________________________ Dated: _______________________