Registration Form

Registration Form

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Registration Form for Legacies

Name:
1st Line Address
City
State
Zipcode
Daytime Phone
Email Address
Registration (includes lunch)	Friday - $35 Saturday - $35 Both days - $50
	Late Registration Fee (applicable after Sept 19th)
Handicapped Access	yes no
Special Needs?
Payment options: (we are unable to accept credit card payments online)
I am sending a check for the total amount today. Please make checks payable to Lewis & Clark College and Send to: MSC 37, 0615 SW Palatine Hill Rd., Portland, Oregon, 97219-7899. I will call you to pay by credit card 503-768-7207(Visa or MasterCard). I will fax my credit card information 503.768.7205 (Visa or MasterCard)
Total Cost