1996-1997 Tri-District P.E.T.S. Registration Form

[Rotary Wheel Logo]

Rotary Districts 6250, 6270, and 6220

The Official CyberRegistration Form for the Conference

==================================================== Please Print this form out and mail in with your payment. ====================================================

Tri-District PETS
Registration Form
For Incoming Club President on July 1997
The complete package for the Incoming Club President includes
all materials, program costs, breaks, hospitality periods, and all 

The Registration Fee before March 15, 1997 is $125.00. $_______

The Registration Fee after March 15, 1997 is $150.00.    $_______

Please indicate your Arrival Date: _____________________________
Please indicate your Departure Date: ___________________________

Please indicate the meal & the $ amount for each meal your
Spouse or Guest will be attending by filling in the blanks 
opposite each meal.

Friday April 4, 1997		Banquet		$11.50	$________

Saturday April 5, 1997		Breakfast		$  9.00	$________

Saturday April 5, 1997		Luncheon		$  7.50	$________

Saturday April 5, 1997		Banquet		$19.00	$________

Sunday April 6, 1997		Breakfast		$  9.00	$________

					Total		        $  56.00	$________

There will be provisions for those with DIETARY restrictions 
or other reasons to receive special meals. If this is a consideration
for you, please indicate your preference here and also notify the
Oshkosh Hilton when you make your room reservations.

			TOTAL AMOUNT ENCLOSED: $_________________	


Tri-District PETS
April 4, 5, 6, 1997, Oshkosh, WI.
Registration Form
Incoming Club President July 1997

First Name: ____________________________ 
Last Name: ____________________________
Name Of Rotary Club: __________________________________
District # _________
Badge Name / Nick Name: _______________________________
Spouse / Guest Name: _____________________________________
Address: ________________________________________
City: _________________  State: ____ Zip Code: ___________ 
Home Phone: _______________________________ 
Work Phone: _____________ Fax: _____________ 
E-mail Address:______________________
Number of Members in your Club: _____             
Are You A Paul Harris Fellow  ?    Y       N
Is Your Spouse a Paul Harris Fellow ?   Y     N                  
Are You A Benefactor ?    Y       N         
Is your spouse a Benefactor ?   Y     N         
Does Your Club Pay the PETS Reg. ?    Y       N    
Does your Club pay for the Hotel ?   Y     N              
The Meals For your Spouse ?    Y       N 

Please CIRCLE the Y yes or N no to answer the above questions.
Thank You !

REGISTRATION FEES:	$125.00 if received by March 15, 1997. 
			$150.00 after March 15. 1997.
			Make checks payable to TRI-DISTRICT PETS.
			No REFUNDS after March 31, 1997.
   			Complete Enclosed Registration Form. Send TO:
			PDG Robert J. Zimmerman, PETS Chair / Treas.
			1426 21st Ave. South,  Wisconsin Rapids, WI
			54495-5619,  H/715-421-5042 , F/421-1843
Click here to E-Mail Robert J. Zimmerman

HOTEL RESERVATIONS:	 Rooms are available at a special rate 
at the Oshkosh Hilton but you must make your own reservations 
using the enclosed form.

If You Have QUESTIONS ?:

Contact your District Governor Or District Governor Nominee !

	District 6220 - DGN Thomas Kerley 
	75  Utopia Circle 
	Sturgeon Bay, WI.  54235 
	H/414-746-4575 - Fax/414-746-4575
	District 6250 - DGN Sharon Imes 
	3465 Ebner Coulee Rd.
	La Crosse, WI.   54601 
	H/608-784-8071 - W/608-782-0835 - Fax/608-784-7414
Click here to E-Mail DGN Sharon Imes

District 6270 - DGN Dave Rowland 245 Main St. Racine, WI. 53403 H/414-638-1352 - W/414-637-0900 - Fax/414-639-2433

Please be aware that your PHOTO will be taken on Saturday April 5, 1997 !

Tri-District P.E.T.S. Homepage/P.E.T.S. Council Member Roster/P.E.T.S. Mission Statement /P.E.T.S. History /P.E.T.S. Registration Form / P.E.T.S. Schedule of Events

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Please visit again in the future. Thank you very much.

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