PNW District Optimist International - 2nd Quarter Regional Meetings
Second Quarter 2012
Registration: $35 US and CA

Please complete an individual form for each member that you are registering. This will allow us to communicate with them as necessary. After you select submit, an acknowledgement will appear on the screen that your information has been received.

Payment of multiple members may be combined on the same check. Please mail to PNW District Optimist, Mary White, District S/T, 6907 NW Anderson Avenue, Vancouver, WA 98665; phone: 360.695.1359.
Name *
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Email address *
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Club name *
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Club number
32 - xxx
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Zone number
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Club or District Office
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Twin Falls
Please check if attending this meeting. Registration: $35 US or CA
Keizer
Please check if attending this meeting. Registration: $35 US or CA
Port Gardner
Please check if attending this meeting. Registration: $35 US or CA
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