REGISTRATION FORM FOR SEPTEMBER 11 WRITER'S CONFERENCE

Please make reservations for ___ adults (@ $25 each) and ___ students (@ $15 each) for Saturday, September 11, 2004.

Name                                                                                                                                                                                

Address                                                                                                                                                                            

City / State / Zip                                                                                                                                                           

Email                                                                                                                                                                                

Would you like to be informed of upcoming events hosted by the Yankton Area Writer's Club?

                                        Yes                                                             No                    

Please mail this form by September 1, 2004 to:

C. Gartner, PO Box 261, Crofton, NE 68730-0261