2011 PLIM Two-Day Fall Survival Conference
PRE-REGISTRATION SIGNIN/RECEIPT
Name _______________________________________________________________________________
Address _____________________________________________________________________________
City State Zip ________________________________________________________________________
Phone # _______________________________________ Email ________________________________
Donations (Must
be paid in advance of next meeting):
$20 ___ $25 ___ (couples) Each Past session: $25 ___ $30 ___ Cash or Check # __________
(Seniors) $15 ___ $20 ___ (couples) Each Past session: $25 ___ $30 ___ Cash or Check # __________
(At the door) $25 ___ $30___ (couples)
Date: ญญญญญญญญญญญญญญญญญญญญญญญ__________________________
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2011 PLIM Two-Day Fall Survival Conference
PRE-REGISTRATION RECEIPT - SEATING IS LIMITED
Membership Donations include: free handouts, free Annual PLIM Report Subscription, free audio CDs, $10 for videotapes of each session (normally $20). Book recommendations will also be given from time to time as part of the membership fee.
Name _______________________________________________________________________________
Donations (Must
be paid in advance of next meeting):
$20 ___ $25 ___ (couples) Each Past session: $25 ___ $30 ___ Cash or Check # __________
(Seniors) $15 ___ $20 ___ (couples) Each Past session: $25 ___ $30 ___ Cash or Check # __________
(At the door) $25 ___ $30___ (couples)
Date: ญญญญญญญญญญญญญญญญญญญญญญญ__________________________
P.L.I.M., Inc. (a 501c(3) nonprofit organization);
P. 0. Box 14‑6217; Chicago, IL 60614‑6217; 312/943‑PLIM
Visit our Website at http://www.plim.org and e‑mail us at plim@plim.org
You can e-mail PLIM 
,
write to PLIM, Inc. at P.O. Box 14-6217 Chicago, Illinois 60614-6217, or call
the PLIMLINE: (773) 509-8124.
This site was last updated 912/2011.