To Pay by Money Order or Check:
Please print this page, fill in the blanks, include Money Order or Check
payable to: Children’sCraniofacial Association/Cher Convention, and
Mail to: Cher Convention 2006, 3552 Kelton Avenue, Los Angeles, CA 90034
If you have any questions please email: MaryLadd@CherConvention.com.
Amount of full payment: __________________
Registration
Form:
Please fill in the following information, as it should appear on your receipt,
for each person that is registering.
First and
Last Name: _________________________________
Mailing street address: _________________________________
city: _________________________________
state: _________________________________
zip code:
_________________________________
E-mail address: _________________________________
Phone:
_________________________________
If staying at the Marriott Warner Center please enter your Hotel Registration
Number: _________________
Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.
First and
Last Name: _________________________________
Mailing street address: _________________________________
city: _________________________________
state: _________________________________
zip code:
_________________________________
E-mail address: _________________________________
Phone:
_________________________________
If staying at the Marriott Warner Center please enter your Hotel Registration
Number: _________________
Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.
First and
Last Name: _________________________________
Mailing street address: _________________________________
city: _________________________________
state: _________________________________
zip code:
_________________________________
E-mail address: _________________________________
Phone:
_________________________________
If staying at the Marriott Warner Center please enter your Hotel Registration
Number: _________________
Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.
First and
Last Name: _________________________________
Mailing street address: _________________________________
city: _________________________________
state: _________________________________
zip code:
_________________________________
E-mail address: _________________________________
Phone:
_________________________________
If staying at the Marriott Warner Center please enter your Hotel Registration
Number: _________________
Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.
Please review the information you've entered for accuracy.