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Pre-Register for the Convention until July 9th by completing this
form.
Full Name________________________ AA__ Al-Anon__
Address _______________________
Badge Name_________
City_________________State___Zip _______
Registration Fees:
__ $25 At the Door
Make Checks Payable to & Mail to:
__ $20 Pre-Register
by July 9 th Lubbock
Caprock
Convention
P.O. Box 6511
__ $2.00 Coffee Club Lubbock, TX
79493-6511
__ $15.00 Banquet Reservation
__ $40.00 Golf Tournament at
(Golfers
must be registered for the convention)
$_____Scholarhip Donation
Total Enclosed $_______
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