2017 AZ NOW STATE CONVENTION REGISTRATION
(Coffee, Light Breakfast and Lunch INCLUDED*)
Name (Please Print) __________________________________________________
Address ____________________________________________________________
City/State/Zip ________________________________________________________
Phone ____________________ Email ____________________________________
NOW Member? YES NO Chapter Affiliation, if any ______________________
Your Early Registration will include a chance raffle to AZ Coalition to End Sexual & Domestic Violence's Gala, May 13th evening event (a $200 value) www.acesdv.org. Register by May 1, 2017 and your name will be placed in the drawing for two Gala tickets. Winner must be available to attend the event to accept tickets. You will be notified by phone or email, by May 6th if you win the Gala tickets.
Early Registration (5/1/17) NOW Member (includes Gala drawing) - $30 $________
Registration Fee NOW member at door - $ 35 $________
NOW Member Registration Sliding Scale - $12 to $29 $________
Non-member Registration Fee - $35 $________
Student Registration - $12 $________
Donation to help cover cost of convention $________
Total Enclosed (check or money order only - no credit card
processing available) $_________________
I would like to volunteer to help at the conference. _______
I need a ride to the conference. ________
I need childcare ________
* Special request for lunch (vegan, vegetarian, gluten free, etc):
___________________________________________________________
Mail registration no later than May 1, 2017 to: 2017 NOW Convention Registration, c/o Ginny-Lee Richardson, 10725 West Mission Lane, Sun City, AZ 85351. After May 1, register by email at glrichardsonNOW@gmail.com. You may pay at the convention. For more information call: 623-937-4300. |
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