ALL REGISTRATIONS ARE $15 EACH

EVERYONE MUST HAVE A NAME TAG

Pre-Registration must be received
by July 15, 2010

(Registrations accepted at the door)

SORRY, NO PETS ALLOWED

 # Attending

________  AA @ $15

________  Al-Anon @ $15

________  Alateen (FREE)

________  Others

________  TOTAL AMOUNT ENCLOSED 

Mail Registrations and all checks payable to: 

Convention Treasurer
P.O. Box 251223
Little Rock, AR 72225

    Print Names to Appear on Name Tags, Include Homegroup                    

AA ___________________________________________

___________________________________________

HOMEGROUP ___________________________________________

AL-ANON  ___________________________________________

___________________________________________

OTHERS ___________________________________________

  ___________________________________________

      ALATEEN  ___________________________________________

 
All above reservations will be held under the name of: