Florida District of CKI
Leadership & Training Conference
September 2-4, 2011 ●
Camp Kiwanis
● 19300 SE 3rd Street, Silver Springs, FL
R
egister by August 24th to secure your t-shirt and your spot!
First Name
Last
Gender
Female
Male
Shirt Size
S
M
L
XL
XXL
XXXL
Email:
Home Phone:
Cell Phone:
CKI Club
Name:
Florida International University
Palm Beach State College
Devry University
Eckerd College
Florida College
Florida Gulf Coast University
Florida State University
Johnson & Wales University
Manatee Community College
Saint Petersburg College
Santa Fe Community College
Southeastern University
St Matthew`s University
Stetson University
University of Central Florida
University Of Florida
University of South Florida - Sarasota
University Of South Florida - St. Pete
University Of South Florida - Tampa
University of Tampa
Kiwanis
Kiwanis Foundation
Saint Leo University
St. Johns River State College
(CKI Member & Advisors Only)
Are you an
officer?
enter title:
Are you a
Vegetarian?
YES
Any
food allergies?
if so, please list
LTC: Leadership and Training Conference
$
Any Special Notes?