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Please print & complete this form only if you wish to register by mail.
To register online, go to Event Calendar page
Name:_______________________________________________________________________________
Address:_____________________________________________________________Apt._____________
City:________________________________________________State:____________ Zip:____________
Telephone: (land line)____________________________(cell)___________________________________
Email:_______________________________________________________________________________
Registration Fees:
| SPEAKER | DATE | # ATTENDING | COST EACH | TOTAL | | Gilmer | September 15
| | $22 | | | Huston | November 8 & 15
| | $40 | | | Foley | December 2
| | $22
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Enclosed is my check for $___________ Check #___________
Your check will be your reservation
Mail to: Lifetime Learning FOR OFFICE USE
P.O.Box 513 Date rcvd: __________
Brenham, TX 77834
Amt rcvd: $ _________
Phone: 979-337-4928
# Attending _________
Email: info@lifetimelearningbrenham.org
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