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2017 OIW ASSEMBLY REGISTRATION FORM

Kansas City, Missouri

Sept. 14, 2017 - Sept. 17, 2017

PRINT OUT REGISTRATION FORM & MAIL IT TO:

OIW, PO BOX 1650, JOHNSTOWN, COLORADO 80534

I am a current OIW member with dues paid (circle one):

   YES    NO

I am paying my 2017 dues of $30.00/year now (or $45.00 for a family membership)

$

I am paying a deposit of $200 for the following: (Balance of $275)  
          Current OIW Member $    
             Spouse of OIW Member
                        - Add $15 if spouse is not a current OIW member $    
             Friend of OIW Member $    
                    - Add $30 if friend is not a current OIW member $    

I am paying the following fees in full:

 

        Current OIW Member -- Assembly fee of $475 per person*

$

           Spouse of OIW Member -- Fee of $475*

$

                    - Add $15 if spouse is not a current OIW member $
             Friend of OIW Member -- Fee of $475* $
                    - Add $30 if friend is not a current OIW member $

Full payment is due by September 1, 2017

 

Total enclosed with registration (plus dues if applicable)

$

*DOES NOT INCLUDE HOTEL COSTS!

Full payment is due by September 1, 2017!

No refunds after August 20, 2017!

 

Name(s) ______________________________ & _______________________________

Address _____________________________________

City, State, Zip _______________________________

Phone _______________________________________

Email Address ________________________________

Please send check or money order to:

OIW 2017 Assembly, P.O. Box 1650, Johnstown, CO 80534

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