Midwest Camp of Instruction
Registration Form





Name ______________________________________________________

Address _____________________________________________________
       
            ______________________________________________________
  
            ______________________________________________________


Phone ________________________________

E-mail _________________________________

Unit ______________________________________ (If Applicable)

Brief Description of Impression:

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________


Registration Fee is $36.00

Make Registration Payable to Phil Campbell

Registration is to be sent to:

Phil Campbell
12253 Strang Line Rd., Apt 414
Olathe, KS 66062

Registration deadline is JULY 31st, 2003!  ABSOLUTELY NO LATE REGISTRATION!!

Any Questions or Comments can be addressed to:
Jessica Underwood             or                      Phil Campbell
[email protected]                                       [email protected]
(417) 866-6528
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