2011 CSCO ANNUAL MEETING REGISTRATION FORM

(4:00 PM, Sunday October 16 to 6:00 PM dinner Monday, October 17, 2011)

Benedict Inn Center, 1402 Southern Ave, Beech Grove, IN 46107

  REGISTRATION/DONATION (Please check one):

[  ] VOTING MEMBER. The registration fee for voting members is $100.00 which is the membership dues.                [  ] FINANCIAL SPONSOR. Sponsors give 1% of their new income.

[  ] ENDORSER.  The registration fee for endorsers is $50.00. Should you later join CSCO, your registration fee will be applied to your 2009 membership contribution.

[  ] OBSERVER. The registration fee is $50.

[  ] I CANNOT ATTEND THE 2011 ANNUAL MEETING but would like to donate a contribution to CSCO as a: [ ] voting member, [ ] supporter, or [ ] friend  (I’m with you in spirit even though I can’t attend).

ROOM AND BOARD REQUESTED (Please check one):

The total cost for two nights 5 meals: single $140 [  ]; double $120 [  ]

The total cost for one night 4 meals: single $90 [  ]: double $80 [  ]

[  ] The total cost for meals for local commuters - no overnight stay  is $40.

 CALCULATING YOUR TOTAL COSTS: 

Please send this completed form along with your check written out to “Christians Supporting Community Organizing” by Sept 30, 2011 to Dick Righter, 1512 Cory Drive, Dayton, OH 45406 – Phone 937-277-7102

Funds are available to assist Members with travel expenses.  Please let Dick Righter know if you need financial assistance in order to participate with us. Transportation instructions will be sent to registrants.

QUESTIONS/COMMENTS - contact Dick Righter if you have any questions at righterwmx@aol.com or (937) 277-7102).

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  CSCO, P.O. Box 60123, Dayton, OH 45406; email: cscocbco@charter.net phone: 937-276-4077