2010 BLS LMI Conference Registration

Guests may attend the Monday night reception, and the Tuesday luncheon. Please fill out the form below for you and your guest.

ATTENDEE:
Full Name (Last, First M.I.)     
Name on name tag               
Title                                    
Organization                        
E-mail                                 
Phone                                 
Fax                                     
Please indicate any special accommodations or requests

Award Luncheon Selection PLEASE SELECT YOUR PREFERENCE Whole Grain Pappardelle (vegetarian) Meatloaf Baked Walleye

GUEST (for reception and/or luncheon):
Full Name (Last, First M.I.)     
Name on name tag               

Banquet (Mon. evening, cost $56.00)     Award Luncheon (Tues., cost $34.00)

Please indicate any special accommodations or requests

Award Luncheon Selection PLEASE SELECT YOUR PREFERENCE Whole Grain Pappardelle (vegetarian) Meatloaf Baked Walleye

*Cost will be added to hotel bill