REGISTRATION FORM FOR ATLANTA HEARS CONFERENCE 99
hearing better @ Y2k.com
( not an email address)
August 13-15, 1999 Unicoi State Park, Helen, Ga
This registration does not include the room reservations, which must be made separately with Unicoi or other facilities. Room deposit and reservation at Unicoi must be made before July 10th to insure a room will be held for you. Registration limited to 200 people.
Attendee Name (as it will appear on badge): _________________________________
SHHH Chapter or Group Name: _________________________________
City: _____________________________ State: ______ Zip: _________
Daytime phone: __________________ Evening Phone: _______________
Email address: _________________________ FAX: _____________
Other Family Attendees
Name (as it will appear on badge): __________________________________________
REGISTRATION RATES Before July 10 After July 10
(Includes all Meals EXCEPT the Banquet)
Attendees (Number) __________ @$45.00 each @$65.00 each
Banquet per person __________ @$20.00 each @$20.00 each
Total Amount Enclosed ___________ __________
Signed: ________________________________________ Date: _________________
Mail this form and your check or money order made payable to ATLANTA HEARS, PO Box 501124; Atlanta, GA 31150. Registration limited to 200 people so register early and reserve your place.
All sessions will be captioned. ALDs and interpreters will be available.