Please print and return this form with your payment to the address below.

Registration Form - 13th Annual Ohio Country Conference

Sign up for:

___ Two Day Conference Registration Cost	$70.00
___ Pre-registration (before 3/1/2009) including a BRBHS Membership* (before 3/1/06)	$65.00
___ Pre-registration (before 3/1/2009) without a BRBHS Membership (before 3/1/06)	$60.00
___ BRBHS or WCHS Members	$50.00
___ WCCC Student/Faculty (with ID)	Free
___ I will attend the Saturday evening reception at Bushy Run Battlefield Museum (Note: a $5 donation is requested for guests that did not register for the conference)	____ Number attending

 

 

 

 

 

 

 

 

 

*Bushy Run Battlefield Heritage Society benefits include a 10% dicsount at the gift shop, free
admission to Bushy Run Battlefield, reduced admission to all PHMC sites, and the quarterly
newsletter. Membership good through 2009.

 

Name: ________________________________________________________________

Address: _______________________________________________________________

City/State/Zip: ___________________________________________________________

Telephone: ____________________________ Email: ____________________________

Questions? Please call 724-527-5584
Or email davmiller@state.pa.us

Make checks payable to: BRBHS