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FALL RALLY LEADERSHIP CONFERENCE ROOM ASSIGNMENT REQUEST FORM Minnesota-Dakotas District Key Club November 6-7th Fergus Falls, Minnesota List name and gender of all attendees in the grid below. Please check whether you are requesting a quad, triple, double or single room. Make certain to places males and females in separate rooms. Please verify correct name and spelling and print neatly as we shall use the names as listed below for Convention name badges. Four people will be placed in each room unless you specify on the grid you want a triple, double or single. Your submission of this list does not guarantee that all of your students will be rooming together as you request. The best way to ensure your requested room assignments is to submit your registration as early as possible. Attach additional sheets if necessary. Key Club or Kiwanis Club of ___________________________________ Room # ____ Name

Room # ____ Name

Room # ____ Name

____ Quad

____ Quad

____ Quad

___ Triple

___ Triple

___ Triple

___ Double ___ Single Check one Gender Student Adult Male

Female

First Timer

Officer

___ Double ___ Single Check one Gender Student Adult Male

Female

First Timer

Officer

___ Double ___ Single Check one Gender Student Adult Male

Female

First Timer

Officer

Advisor / Spouse / Children / Bus Driver Rooms Advisor note: if your spouse or children are accompanying you, please list their names. They will not be charged unless the spouse is a Convention attendee or they take meals with the Convention. List any Bus Driver names.

2010-2011 President in attendance? ____ N

_____ Y Name _____________________


FallRallyRoomAssignmentRequestForm