Form

2010 Junior Achievement of West Central Florida

Annual Board Retreat

in partnership with Junior Achievement of Central Florida (Orlando)

Thursday, September 16 ^th , 6:00 pm Reception

thru Friday, September 17 ^th , 3:00 pm

Disney’s BoardWalk Inn

2101 Epcot Resorts Boulevard

Lake Buena Vista, FL 32830

FIRST NAME:

LAST NAME:

COMPANY:

TITLE:

ADDRESS:

CITY:

STATE:

ZIP:

WORK PHONE:

EMAIL:

Yes, I will be attending the 2010 Board Leadership Conference. I understand the conference fee is $150.00 which includes Thursday's Reception and Dinner as well as Friday's breakfast, lunch, break and materials.

I understand if I am not able to attend the entire conference, I will only be invoiced for a portion of the fee.