District 43 Spring 2010 Conference

April 23rd & April 24th, 2010

Arlington Hotel
239 Central Avenue
Hot Springs, AR 71901

Registration

LAST Name ______________________________________________________

FIRST Name _____________________________________________________

Street Address __________________________________________________

City _____________________________________________________________

State ____________________________________________________________

ZIP ______________________________________________________________

Telephone _______________________________________________________

Email ____________________________________________________________

Club Name and Number ________________________Division and Area _______

Circle your highest Toastmaster level(s): CC AC-B AC-S AC-G CL AL-B AL-S DTM

Have you served as District Governor or International Director? DG PDG ID PID

Is this your first District Conference? ______ Yes _____ No

Non-Toastmaster Guest/Spouse Name(s) ____________________________________

Full registration includes all sessions and contests, Friday evening dinner, Saturday
lunch and dinner, and after contest entertainment each evening.

All Toastmasters attending any session, meal, or contest must pay the registration fee.
Non-Toastmasters guests or spouses may purchase meals only.

Refunds: By district policy, registration, meals, and deposits are only refundable until
April 9, 2010 (two weeks before the conference) when requested in writing. Hotel
reservations and refunds are the responsibility of each individual and contingent on
hotel policy. Neither District 43 nor the conference committee bears responsibility if a
hotel refund does not apply.
The Arlington Resort Hotel & Spa is offering a $99.00/night Toastmasters rate. Call
(800) 643-1502 or e-mail info@arlingtonhotel.com to reserve today. Visit
www.arlingtonhotel.com for more information about our conference site.

Checks should be made payable to: Toastmasters Spring 2010 Conference.

Mail registration and payment to: John Baine

Post Office Box 1287
El Dorado, AR 71731-1287

Full conference package (includes everything below)

Early Bird Postmarked on or before 12/01/09: $95 (Best Value)
Regular Postmarked after 12/01/09 but before 04/01/10: $105
Late Postmarked on or after 04/01/10: $125

Registration is required to attend any session $30

Early Bird / Regular Late

Friday evening buffet $30 $40

Saturday lunch buffet $20 $30

Saturday dinner buffet $30 $40

TOTAL ______________

AMOUNT PAID ______________

Emergency Contact: Please give us someone to contact in case of emergency:

Name __________________________________________

Relationship _________________

Home Phone ____________________________

Other Phone _________________________

Please note any special needs, such as dietary, allergy, medical, wheelchair access,
etc. that may require prior arrangements or emergency treatment.
_____________________________________________________________________

_________________________________________________________________________..

Please check www.district43toastmasters.org for conference updates.