WVHC/WVEC Fall Conference:  October 21 – October 23, 2016, Camp Virgil Tate:  Green Voices
1400 Camp Virgil Tate Rd, Charleston, West Virginia 25312

Please sign up in advance for lodging and meals.  Registration must be submitted by October 10 in order to have a complete meal count.
If you are a couple or family group, only one registration form is needed.
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Name: *
Address: *
Email: *
Phone Number: *
Number of people being registered: *
Select your lodging: *
Required
Select your nights: *
Required
Indicate if you are staying in Maxwell Lodge and wish to be assigned a roommate if available for a $31.80 per night per room cost reduction.  If you are a couple or family group registering together, you may indicate private room. *
Required
If you have selected a roommate for Maxwell Lodge who is registering separately, please give the name:
Total Cost of Your Lodging: *
Select Your Meals: *
Required
Total Cost of Your Meals: *
Donation amount to help with conference expenses and/or to benefit the hosting organizations.
Total dollar amount for registration, please add your lodging, meals, and donation. *
Method of Payment: *
Required
Please comment on anything else we should know about your registration, or tell us if you have special needs for lodging, meals, or the meeting.  You may make adjustments to your form online.
What are your goals in attending this conference?  What are your primary areas of interest?
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