| Online Registration [SAMPLE FORM - NON-FUNCTIONAL] District 4 Spring Conference May 18 - 19, 2007
Early Bird Not Avail | May 16-19 Pricing | Attending (Choose One)
$75 | $110
|  | Full Conference (Friday Night & All Day Saturday) Friday Reception, New Clubs Rally, Hall of Fame, and Table Topics Contest. Saturday continental breakfast, Educational Sessions, C&L sit down luncheon, Business Meeting, and International Speech Contest
$20 | $30 |  | Table Topics Contest (Friday) Includes New Clubs Rally, Hall of Fame, reception with hors d'oeuvres, no host bar, and opening ceremony
$65 | $80 |  | Saturday Only (All Day) Continental breakfast, Educational Sessions, C&L sit down luncheon, Business Meeting, and International Speech Contest
$20 | $30 |  | Breakfast and Educational Sessions (Saturday) Continental breakfast and two Educational Sessions.
$35 | $45 |  | Communications & Leadership Luncheon (Saturday) Make meal choice below. (Note that we cannot guarantee meal availability after May 15)
$15 | $25 |  | International Speech Contest Only (Saturday) May also attend Business Meeting (no meal)
$35 | $55 |  | Both Contests (Friday and Saturday) Friday: Table Topics Contest and Hall of Fame (includes Reception) Saturday: International Speech Contest (may also attend Business Meeting - no meal)
Method of Payment Credit Card (PayPal) Pay at Door |  | Saturday C&L Luncheon Meal Choice Chicken Vegetarian

*Required Information
*Attendee's Name |
*Email |
*Club Name (Home Club Only) | Club Number
Street Address |
City | Zip Code
Phone |

Any Additional |
Please read notes below before submitting registration. |

Early Bird Pricing will be applied to all registrations submitted before 5/16. Credit Card (PayPal) PayPal accepts all major credit and debit cards. PayPal registrations will be accepted through 5/17. You will need to complete PayPal transaction and submit final Conference Registration Confirmation. Simply confirming registration does not complete PayPal purchase. If the PayPal window does not open, you may need to disable your browser's "popup blocker." Cancellations Cancellations received before 5/15 will be refunded and not billed as no shows. (The District must provide non-refundable headcount to hotel.) Pay at Door Only cash or checks can be taken at the door - no credit cards. Make check payable to District 4 Toastmasters | Check in Advance Mail with registration form to Jane Doe Toastmasters 123 Memory Ln. Smallville, USA 99999 Make check payable to District 4 Toastmasters As the conference is this week, we are asking everyone to use Credit Card (PayPal) or Pay at Door (cash or check) as their Method of Payment.