3rd Women's Sailing Conference  Enrollment Form
June 5, 2004, Marblehead, MA 
 Registration form to be submitted later.

Name:
Address: 
City: 
State:    ZIP: 
Phone:    
Fax: 
Email: 

Price:  $100 NWSA Members; $135 Non-Members.  Surcharge of $15 after 5/1/04.

Terms:  $50 deposit required.  Balance due by May 1.  Refunds allowed, less less a $25 cancellation fee, up to 1 month prior.  No refunds after that date unless we fill your spot.  

Included:  Up to 4 workshops, continental breakfast, lunch, dinner, raffles, speaker.

Enclosed is  my check for $    
     (Make payable to Women's Sailing Association.)

Charge to:     Visa      Mastercard 
No.
Expiration Date:   /

Authorized Signature:  ______________________________________________

Mail to:  NWSA, 70A Pleasant St., Marblehead, MA 01945
or Fax to:   781 631-2889