SRE Registration Form

You must mail a check or money order to be registered for both the event and the hotel.
Make Check payable to: Speaking Up for Us SRE

Mail to DRC/SRE, PO BOX 2007, Augusta, Maine 04338

Name:_______________________________________________________________________________

Street Address:_____________________________________________________________________________

Town/City:___________________________________________________________________________

State: __________ Zip Code: ___________ Telephone:_______________________________________

Dietary Needs: _______________________ Special Needs: ___________________________________

Deadline Date is August 31, 2007 No refunds, substitutions will be accepted.

Question: Do Staff have to pay? Answer: Yes!

SUFU Registration Fee $65 per person + Room fee below

Roommates should send all registration forms and checks in one envelope.

Name:_______________________________________________________________________________

2 People in a Room cost $51 each

Name:_________________________________Name:________________________________________

3 People in a Room cost $40 each

Name:_____________________Name:_____________________Name:__________________________

4 People in a Room cost $30 each

Name:________________________________ Name:_________________________________________

Name:________________________________ Name:_________________________________________

Total Amount Enclosed$_______________

Contact: Dixie Leavitt at 1-877-207-4077 or e-mail: dixieleavitt@gwi.net

If you have problems or questions:
Please Do Not call the DRC or Sunday River!