March 2, 3, & 4, 2012
DeKoven Center, Racine, WI
|Please Print Clearly.|
|City, State, Zip:|
|Enclosed is my check for: $___________
I am enclosing an additional $___________ to be contributed to the Scholarship Fund.
|Meals:||Please circle one:  Vegetarian  /  Non-Vegetarian
* All meals are included. Vegetarian selections are limited. If you have special dietary concerns there are microwaves and refrigerators available. Please bring your own food. We regret that we cannot make a price adjustment for this.
|Pricing Structure: DeKoven Center is located on the shores of Lake Michigan in Racine, Wisconsin. Directions will be provided upon receipt of registration.|