Name
Email Address
Street Address
City
Zip
Phone
Local Girl Scout Service Unit
I am a Discoveree 2009 Workshop Leader.
I am a Girl Scout in 10th – 12th Grade. I use a wheelchair or have difficulty with stairs.
Choice 1
Choice 2
Choice 3
Choice 4
Session 1
Session 2
Session 3
Session 4
Registration Fees Enclosed for:
Adult @ $28 ea
- or -
Girl Grades 10-12
@ $7 ea x
workshops
Lunch $7.00 (each): Each lunch includes potato chips, potato salad & cookie.
Check or Money Order enclosed payable to: GSNC
- or -
Charge my
Mastercard /
Visa
CC#
Exp
/
Signature
Note: You only need to print page 1
STEP 1 Read each workshop description thoroughly before
making your choices. Choose the workshops you
most want and list them in order of preference. As
registrations are received, every effort will be made to give
you your first choice in each session. Alternate choices (in
the order you listed) will be assigned if your first choices
are full.
STEP 2 AFTER making your 1st, 2nd, 3rd, & 4th choices,
review them and fill in your workshop selections per each
session.
STEP 3 All Registrations are NON-REFUNDABLE.
Adult Registration fee: $28.00
Girl Scouts Grades 10-12 fee: $7.00/per workshop
STEP 4 Include payment or credit card # and mail/fax/e-mail to:
Sandi Mulkey
4233 Goldenhill Drive
Pittsburg, CA 94565-6210
Ph: 925-439-3382 FAX: 925-439-1502
E-mail: brakes225@aol.com Print 2 copies - 1 to send to Sandi and one to keep to compare with confirmation card when received.
STEP 5 Wait 3 to 5 weeks for your confirmation card. If you have any questions
about the registration process or would like to make a change with workshops
you are assigned, contact Sandi. Changes will be made if space is available,
provided that the request is made prior to January 29.
Due to the Workshop Leaders having prepared for the
numbers in their workshop, there will be NO CHANGES
MADE THE DAY OF DISCOVEREE.
