ada conference Registration 2011 by xiagong0815


									                       ADA Issues & Resolutions Workshop
                       April 17-19, 2011
                       Putting the pieces Together XV:
                       Connecting the Teams

Hosted By:                                  &
Conference Registration Form

When:           April 18 & 19, 2011
Where:          Icicle Village Resort, Hwy 2 Leavenworth, WA 98826
Registration Fee:     $100.00 (includes workshop and Monday lunch)
Make Checks payable to:    “ADA Workshop”

Send Remittance to:        Karla Gibbons c/o Spokane Transit
                           1230 W Boone Ave
                           Spokane, WA 99201
                           Fax: 509-325-6030

Deadline: Register by March 15, 2011. You may return this form by fax or email
and follow with a check by mail. Please complete one form per person.

Name:                                  Title:

Agency:                                Address:

Phone/Fax:                             Email:

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