C.O.C.A. Times

HOUSTON, TEXAS 2011 COCA CONVENTION
REGISTRATION FORM
SEPTEMBER 16-18,2011
Please Print
COCA Member Name: - - - - - - - - - - - - - - - - - -
A Is o Registering: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Address: - - - - - - - - - - - - - - - - - - - - - -
Phone #: - - - - - - - - Alternative # - - - - - - - - - - -
E-Mail Address: - - - - - - -- - - - - - - - - - - - -
1 will be selling on Friday during room-to-room trading:
YES
I am interested in optional bus transportation at an additional charge: YES
NO
NO
Early Registration Fee (before April 10, 2011)- $169 per person
Total number of persons attending convention ____ @$169 = $ _ _ _ _
Late Registration Fee (after April 10, 2011 )- $189 per person
Total number of persons attending convention _ _ _ _ @$189 = $ _ _ _ _
PRICE OF CONVENTION INCLUDES 2 DINNERS AND A LUNCH ON SA TU RDA Y
CHECKS PAYABLE TO: COCA
MARSHA BLAU
7623 N. LAKE DRIVE
Fox POINT, WI 52317
Hotel accommodations are to be made directly with:
The Hilton Hotel--ask for the COCA rate or
http://www.hilton.com/en/hi/groups/personalized/H/HOUWCHFCOCA20110914/index.jhtml?WT.mc id=POG
Room rates: $99 per single occupant, $109 per double occupant
Suites available for an extra $25 per night
Room rates include a full hot breakfast buffet each morning.
PLEASE MAKE YOUR ROOM RESERVATIONS EARLY
COCA as a limited number of rooms available
Hilton Houston Westchase
9999 Westheimer Road
Houston, Texas
713-97 4-1000