I (we) plan to attend the 2009 KOS fall meeting
Name(s)_______________________________________________________________
Address _______________________________________________________________
City, State, Zip __________________________________________________________
Phone _______________________ E-mail____________________________________
Registration Fee $15.00 x ____= $_________
Saturday Banquet $20.00 x ____= $_________
Sunday Box Lunch $7.00 x ____= $_________
Total Amount Due $_________
Registrations received after September 15 will be $20.
Students will pay a $5 registration fee unless they are presenting.
Make checks payable to : KOS
Please mail completed registration to:
Terry Mannell
218 Northridge
Hays, Kansas 67601
In submitting this registration form I (we) understand that KOS is not
responsible or liable for any accidents or injury that might be associated with
the 2009 KOS fall meeting.
_______________________________________________________________________
_______________________________________________________________________
Signatures
Date
(attach additional names and signatures as necessary)