Convention Registration

Please note that ALL Payments are Final.

Name *

Email Address *

Phone Number *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Choose Your Convention Registration

Registration Types *Registration Only ($35)Registration and Banquet ($80)

Banquet Meal Choice

Please choose your Banquet Meal *Pasta RusticaFeta Stuff Chicken BreastSeared SalmonPlease note that the dessert for all Banquet meals is Key Lime Pie

Boxed Lunch Preference

Lunch Preference - Choose your sandwich for Saturday’s box lunch: (Check one)

Lunch Preference *HamTurkeyVeggie

Senior Possibilities Fair

If you are interested in attending the Senior Possibilies Fair, the cost is an additional $5.

Attend Senior Possibility Fair

Attend Senior Possibility Fair ($5)

What print format would you like for the convention agenda?

Agenda Format *BrailleLarge PrintStandard PrintElectronic

Total

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