GOTC@ DFW 2014
JUNE 19- 22, 2014
DALLAS –FORT WORTH, TEXAS
REGISTRATION FORM NAME
BATCH
SPOUSE
BATCH
_
ADDRESS
TELEPHONE (HOME)
(CELL)
E-MAIL CHILDREN (6-11 YRS)
(12YRS and above)
REGISTRATION
$150.00
FOOD (Vegetarian option available)
ADULTS OR CHILDREN 12 YEARS and above @ $170 CHILDREN 6-11 YRS@ $120
I PERSON
I PERSON
(CHILDREN 5 YEARS and UNDER no charge)
TOTAL (US DOLLARS)
Please make check Payable to GOTC 2014 and mail completed form and check to Dr Renu Mohandas 1318 Clearfork Street Lockhart, Texas 78644