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2010 Wine Country Regional On-line Registration

by Shelly Tillery
March 13, 2010


Location of Regional: Friday, November 5, 2010 The Doubletree Hotel 1 Doubletree Drive Rohnert Park, CA 94928 (707) 584-5466 (Group code is: 613) $129.00 per night Click here for on-line hotel accommodations (Breakfast & lunch is included with your registration) Attendees Names: (for additional attendees, please use the "comment" section at the bottom of this registration form)
District/Company
Address City Zip
Phone Fax
E-mail Address (please use "one" e-mail address where follow-up materials will be sent)

2010 REGIONAL REGISTRATION RATES:
	Member	Non-Member
1st Registrant	$150.00	$200.00
Subsequent Registrants	$95.00	$200.00

P.O.#	Credit Card	Visa	MasterCard	AMEX
Billable Amount:$
Credit Card #			Exp.
Billing Address:
Name as it appears on card:
Date:

Comments or additional attendees:

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