To Pay by Money Order or Check:

Please print this page, fill in the blanks, include Money Order or Check
payable to:  Children’sCraniofacial Association/Cher Convention, and
Mail to: Cher Convention 2006, 3552 Kelton Avenue, Los Angeles, CA 90034
 

If you have any questions please email: MaryLadd@CherConvention.com.


Amount of full payment:  __________________


Registration Form:
Please fill in the following information, as it should appear on your receipt, for each person that is registering.


First and Last Name:  _________________________________

Mailing street address:  _________________________________

 city:  _________________________________

 state:  _________________________________ 

 zip code:  _________________________________

E-mail address:  _________________________________

Phone:  _________________________________

If staying at the Marriott Warner Center please enter your Hotel Registration Number:  _________________

Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.


First and Last Name:  _________________________________

Mailing street address:  _________________________________

 city:  _________________________________

 state:  _________________________________ 

 zip code:  _________________________________

E-mail address:  _________________________________

Phone:  _________________________________

If staying at the Marriott Warner Center please enter your Hotel Registration Number:  _________________

Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.


First and Last Name:  _________________________________

Mailing street address:  _________________________________

 city:  _________________________________

 state:  _________________________________ 

 zip code:  _________________________________

E-mail address:  _________________________________

Phone:  _________________________________

If staying at the Marriott Warner Center please enter your Hotel Registration Number:  _________________

Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.


First and Last Name:  _________________________________

Mailing street address:  _________________________________

 city:  _________________________________

 state:  _________________________________ 

 zip code:  _________________________________

E-mail address:  _________________________________

Phone:  _________________________________

If staying at the Marriott Warner Center please enter your Hotel Registration Number:  _________________

Please circle which event/s you are registering for:
Friday Evening Event $95.
Saturday Evening Event $95.


Please review the information you've entered for accuracy.


Back to the Registration