Central Iowa Orchid Society
Speaker's Day, July 20th, 2024
Registration Form

To help us plan for Speaker's Day, we encourage you to fill out this registration form and return it to: Central Iowa Orchid Society, c/o Chris Barck, 16402 J Ave., Perry, IA 50220. We would like these returned by July 5, 2024 if possible.

Please make checks payable to the Central Iowa Orchid Society.

$30.00 per person ($35.00 at the door).

Name: _______________________________________Telephone: ___________________________

Address: _____________________________________ City: ________________________________

State: ___________________________________________ Zip Code: _________________________

Number of people attending: ______________ Email: _____________________________________

Amount Enclosed: $__________________ or:

Credit Card #: _________________________ Exp. Date: MO ____ YR ____ Security code: ______