PARENTS WITHOUT PARTNERS
41st INTERNATIONAL CONVENTION - JULY 5 - 9, 2000
RADISSON PLAZA HOTEL, 815 MAIN ST., FORT WORTH, TEXAS

REGISTRATION FORM

Registration Instructions:
Complete this registration form and send it with payment to Kay Brewer, 1843 Larkspur, Arlington, TX 76013. Checks should be made payable to PWP International Convention. Admission to all events is by ticket only. All payments must be in US dollars. Early Bird Special deadline is March 31, 2000. Regular Early Registration deadline is May 15, 2000. Advance Registration deadline is June 11, 2000. After June 11, 2000 please register on-site. Full payment must accompany this form. Registration may be paid by cashiers check, money order, or by check made payable to PWP International Convention.

Cancellations received in writing by June 11, 2000 will be refunded minus a $10 processing fee. After June 11 and before June 25, 2000, refunds will be considered on a case-by-case basis. NO refunds will be given after June 25, 2000.

All payments, advance or on-site, MUST be in US dollars. Badge replacement fee is $10. Personal checks will NOT be accepted on-site. If paying on-site, please bring a cashier's check, money order or cash.

Registration Information

Membership#__________________________Chapter Name & Number________________________

LastName________________________FirstName__________________

Nickname for Badge________________

Address_______________________________City______________________State_______Zip_____________

Country____________ Phone( )____________ Fax( )_____________ E-Mail__________________________

Circle: Male Female
Is this your first convention? Yes No
Will your children attend? Yes No

Individual to call in an emergency:

Name________________________----------____________________ Phone ________________________

Are you a Former International Board Member? Yes No If yes, position held:

___________________________________________________ When__________________________

It is important to us that you enjoy the PWP convention. If, due to a disability, you have any special needs, accommodations or requirements, please let us know in the space provided and we will do our best to accommodate you.

Special Needs:________________________________________________________________

Please check the appropriate categories:

Full Registration: Includes all meetings, workshops, activities, dances, Awards Breakfast and President's Banquet & Ball. Does not include optional tours or events.

___$135 postmarked by March 31, 2000 ___$150 postmarked by May 15, 2000

___$165 postmarked by June 11, 2000 ___$175 Onsite

___$35 per person Optional Metroplex Bus Tour for Tuesday, July 4, 2000

Individual Tickets: You may purchase individual tickets to each event; however they are subject to availability.

____ ticket(s) $50-President's Banquet & Ball (July 8)* ____ ticket(s) $25-Awards Breakfast (July 6)*

*Included in Full Registration. Please note: A badge will only be issued for full package registrations