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OFFICIAL PRE-REGISTRATION FORM
AMFS MWF GSLAESC
Marriott – St. Louis West
Maryville Centre Drive
St. Louis, MO 63141
Lewis & Clark Discoveries
Please type or Print
Name_________________________________________ Phone (
) ________ ______
Address____________________________________________________________
City_____________________________________________ State
_______ ZIP _________
Society or Club Affiliation
______________________________________________________________
Please Check: AFMS Officer (
),
Delegate ( ),
Judge ( )
MWFS Exec. Committee ( ), Past
President ( ), Delegate (
)
Speaker ( ),
Editor ( ),
Other ( )
List all persons by name who are included in this registration:
_____________________
_____________________________________________________________
_
________________________________________________________________________________
ADMISSIONS- Show Pass
Daily
3 Day Pass Number
Amount
Adults $5.00(daily)/$12.00(3day)
____
_______
______ $_________
Senior Citizens$4.00(daily)/$9.00 (3day) ____
_______
______ $ _________
Juniors $2.00(daily/$5.00(3day)
____
_______
______ $ _________
(6
thru 18)
Children under 5
Free
Free
______
_________
Total
______ $_________
TICKETS FOR MEALS Number Amount
AFMS Delegates Luncheon
$14.00
______ $
________
MWF Executive Committee Luncheon
$14.00
______ $ ________
AFMS/MWF Awards Banquet
$26.00
______ $ ________
Editors Seminar and Breakfast
$14.00
______ $ _______
Total
$ ________
Deadline for Advanced registration is July 15, 2005. NO
EXCEPTIONS
Remittance must accompany the registration form. Make Check payable to:
Greater St. Louis Association of Earth Science Clubs Inc.
send registration form(s) and Check to:
MS. Cherie Vaughn
100 Oriole Drive
St. Charles, MO 63301 |