Registration Form
KOS Fall Meeting

October 2 - 4,  2009
Hutchinson, Kansas

I (we) plan to attend the 2009 KOS fall meeting


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)

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