Page 5 - CALIFORNIA WOMAN - 2024 WINTER EDITION

CALIFORNIA FEDERATION of BUSINESS & PROFESSIONAL WOMEN
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Winter Board of Directors and 64 Annual Public Policy Conference
February 23-24, 2024 – Courtyard Burbank, CA
CFBPW REGISTRATION FORM
Please note: You will be registering for each meeting separately.
PLEASE PRINT ALL INFORMATION – Please, one form for each person attending

NAME: ____________________________________________ Club: ________________________________
ADDRESS: _________________________________________ DISTRICT: _________________________
CITY: _____________________________________________ ZIP: _______________________________

HOME PHONE ______________________________________ WORK PHONE _______________________
E-MAIL ______________________________ __________________________________________________
February 23, 2024 - Winter Board of Directors Registration
__ I will be attending via Zoom and understand the Registration Fees below apply to Zoom participation as well
as in-person.
2023-2024 STATE POSITION: (Select Only One)
_____ State Officer _____ Standing Chair _____ Member
Past State President Special Chair First Timer
_____ District President/Alternate _____ District Representative _____ Guest

REGISTRATION:
Board Meeting - Received by February 14, 2024 $ 20 $ _________
Friday Lunch $ 45 $ _________
ANY Registration Received after 2/14/24 ADD $10 $ 10 $ _________
TOTAL AMOUNT FOR BOARD REGISTRATION $ __________

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February 23-24, 2024 – 64 Public Policy Conference Registration
__ I will be attending via Zoom and understand the Registration Fees below apply to Zoom participation as well
as in-person.

2023-2024 CFBPW PUBLIC POLICY COMMITTEE POSITION:
___ PUBLIC POLICY CO-CHAIR ___ DISTRICT PUBLIC POLICY CHAIR ___ PARLIAMENTARIAN
___
___SCREENING COMMITTEE

REGISTRATION:
Public Policy Meeting Postmarked by February 14, 2024 $ 25 $ _________
Saturday Lunch – $ 55 $ _________
ANY Registration Postmarked after 2/14/24 ADD $ 10 $ _________
TOTAL AMOUNT FOR PUBLIC POLICY REGISTRATION $ _________

TOTAL AMOUNT ENCLOSED – PLEASE MAKE CHECK PAYABLE TO: CFBPW $_________
We apologize for the meal costs, but things are not priced like they were pre-COVID and supply chain issues.

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: