Register for the California PTG State Convention

Download the PDF CA Convention Brochure in PDF format (with registration form) (about 200k)

The PDF registration form can be viewed and printed from any platform (Macintosh, Windows '9x,etc...) with the free Adobe Acrobat reader program. If you do not have Adobe Acrobat, you can download a free copy of Adobe Acrobat Reader for any computer.
California PTG State Convention 2000
Hosted by the Santa Clara Valley Chapter

Registration Form

Name ________________________________
Nickname for Badge _____________________
Address _______________________________
City _________________________ State ____
Zip Code ________ Phone ( )_____________

PTG Member _____ Non Member _____

Chapter ______________ Region/number ____

Spouse or Guest Name ___________________

Is the spouse or guest a member of the Auxiliary? Y N
(Non-Auxiliary registration includes 1yr. Auxiliary Membership)

Questions
Call Roland Kaplan, Convention Chair (408) 927-0620

FEES
Registration includes one superb banquet dinner and concert.
Early Registration Deadline: February 1, 2000.

PTG Member (includes banquet) _____ $175
Non-Member (includes banquet) _____ 225
Late Fee (post mark after Feb. 1) _____ 30
Auxiliary Member (includes banquet) _____ 85
Non-Auxiliary Guest (includes banquet) _____ 85
Additional banquet ticket _____ 40

TOTAL REMITTED $___________

Please indicate meal preference:
Carnivorous ______ Vegetarian ______

Please write check to "California State Conference PTG"
or provide VISA or Master Card information:

Credit Card: VISA MC (Please circle one.)

Card Number ____________________________________________________

Expiration Date _____/_____

Signature for credit card _____________________________________

Please mail payment and registration to:
Douglas Richards
3517 Chablis Drive
San Jose, CA 95132