* Name(s)
* How many people are you signing up for?
* E-mail
* Address
* Phone Number
* Do you work in the food-service industry? If not, please explain in "Comments" area below	Yes No
* What is your accomodations preference? Rates are per bed per night based on a 2-night stay Click HERE for descriptions (opens in new window)	Pinehurst Inn $55 Queen Pinehurst Inn $65 King Pinehurst Inn $75 Suite /w King Nice Cabin $55 Full-Bed (private) Nice Cabin $30 Twin (shared) Nice Cabin $20 Loft (shared) Basic Cabin $45 Full (private) Basic Cabin $40 Single (private) Basic Cabin $30 Full (shared) Basic Cabin $20 Single (shared) Sleeping Bag on cabin floor I do not need accomodations
* How flexible are you with your accomodations preference? (Some selections may no longer be available)
* Sex (for housing)	Male Female Married Couple Multiple Guests
Please house me with
* Would you be interested in a ServSafe sanitation certification course Tuesday afternoon?	Yes No What is Servsafe?
* Would you like to be listed in the retreat's address book to be given to all attendees?	Yes No
Comments: What you would like to see, learn & do at this conference so that we can know how to serve you better.
Can't afford this? (Scholarships may be available)
Would you be interested in helping to sponsor someone in need?
Please PRINT this form before submitting. Send a copy of it with a check/money Order Payable to "Pinehurst Inn" Christian Chefs Fellowship c/o Ira Krizo 17250 Highway 66 Ashland, OR 97520 Call Ira at (541) 488-1002 first to confirm your lodging option
Payment (Call first to confirm lodging option before sending payment)	Pre-Registration: = $70/person + lodging (payment sent before September 1) After September 1 = $75/person + lodging (Call us to hold with a credit-card)
(Please print first for confirmation)