REGISTRATION FORM

North Carolina Yearly Meeting (Conservative) Chowan College, Murfreesboro

7th Month, 10-14, 2002

MAIL THIS FORM TO: Lloyd Lee Wilson

PO Box 647

Woodland, NC 27897-0647

Meals & Beds	7/10	7/11	7/12	7/13	7/14	Sum	Cost Each	Totals
# Beds (2 to a room)							$15.00
# Breakfast							4.00
# Lunch							5.25
# Dinner							5.85
Registration Fee (per family)							10.00	10.00
Contribution to enable others to attend Yearly Meeting
SUM:								$______

NAME:	CHILDREN'S NAMES & AGES
ADDRESS:
CITY: STATE: ZIP:

PHONE NUMBER: ___________________ E MAIL: __________________________

Rooms are air-conditioned and contain two single beds; pillows, linens and towels are not provided.

If you require special assistance, (cannot climb steps, use a wheel chair, need assistance walking to the cafeteria, have particular dietary needs, etc.) please indicate your needs here so we can make the proper arrangements.