Page 6 - CALIFORNIA WOMAN - SPRING EDITION 2023 with all FORMS

CALIFORNIA FEDERATION of BUSINESS & PROFESSIONAL WOMEN
103 Annual Conference
rd
May 19-21, 2023 – Sheraton Ontario Airport Hotel
CFBPW REGISTRATION FORM

PLEASE PRINT ALL INFORMATION – Please, one form for each person attending

NAME: ____________________________________________ CLUB: _______________________________
ADDRESS: _________________________________________ DISTRICT: _________________________
CITY: _____________________________________________ ZIP: _______________________________
HOME PHONE ______________________________________ WORK PHONE _______________________
E-MAIL ______________________________ _________________________________________________

____will be attending via Zoom and understand there is a $45 Registration Fee for Zoom participation.
May 19-21, 2023 – Annual Conference Registration
2022-2023 STATE POSITION: (Circle Only One)
State Officer Standing Chair Member
Past State President Special Chair First Timer
District President/Alternate District Representative Guest

REGISTRATION: (FOR ALL, IN PERSON OR VIA ZOOM)
Early Bird – Received on or before Monday April 27, 2023. $ 45 _______
Received Between– April 28 and May 5, 2023 $ 50 ______
Received (email, fax or telephone) after May 5 and onsite $ 60 _______

MEALS –
Friday Lunch (Cobb Salad) $35 _______
Saturday Lunch (Angel Hair Pasta w/Chicken) $50 _______
Saturday Installation Banquet (Jerusalem Chicken-[Artichokes]) $60 _______
Plus $5 late fees for each meal received after May 5 $ _________

TOTAL AMOUNT ENCLOSED – PLEASE MAKE CHECK PAYABLE TO: CFBPW $_________

I wish to make a separate special Contribution to CFBPW Education Fund payable to
CFBPW Ed Fund. (You may make a Contribution even if you are not participating in
the Annual meetings.) $ __________

POST CONFERENCE BOARD OF DIRECTORS REGISTRATION -
NO FEE REQUIRED BUT PLEASE INDICATE YOUR PARTICIPATION

2022-2023 STATE POSITION: (Circle Only One)
State Officer Standing Chair Member
Past State President Special Chair First Timer
District President/Alternate District Representative Guest

MAIL CHECK, MADE PAYABLE TO CFBPW, AND THIS FORM TO: PHONE/FAX NUMBER:
Katherine Winans – CFBPW Registration 775 267 0539
1171 Chaparral Court, Minden NV 89423
YOU MAY PAY USING ZELLE. SET THIS UP THROUGH YOUR BANK ONLINE. NO FEES CHARGED.
SEND THROUGH ZELLE USING THIS EMAIL: bpwvsd@gmail.com
With Zelle payments you still need to mail or email the registration form as above.

SPECIAL REQUIREMENTS:
__If you have a disability and require accommodation to fully participate in this activity, please check here.
You will be contacted to discuss your specific needs.
__If you have dietary restrictions, please let us know: