*Organization Name:

*Billing Contact:

*Title:

*Billing Address:

*City:

*State: (e.g. TX, OK, etc.)

*Zip:

*Phone:

Fax:

*Email:

Name 1:

Name 2:

Name 3:

Name 4:

TWU will provide one 6' table and two chairs per registration.

Any special equipment needs?

Specific Needs:

I (We) plan to attend dinner at 6 p.m.

Yes
No

Any special dietary needs?

Vegetarian
Other (please specify below)

Dietary Needs:

Please send me an invoice for my registration fee.

Registration fee is $50 for first registrant, and includes table, chairs, sign-age, advertising, parking, and dinner. Additional registrations are $10 each.

Make checks or money orders payable to TEXAS WOMAN'S UNIVERSITY.

TWU Taxpayer ID#: 75-6002618

Send payment to:

Texas Woman's University
Office of Admissions
Attn: Joshua Hancock
PO Box 425589
Denton, TX 76204-5589