Note: this form is an example only.  The 2008 form will be available later

WSHS Annual Trek Registration Form

 Name(s) _______________________________________________________

 Address _________________________________ Phone ________________

 City __________________________ State ________________ Zip ______

Conference Activity	Fee	x Number of Registrations	Total
Full Conference (includes all meals)	$75.00		$
Additional Tickets (for those not attending entire Trek):
Reception at UW Geology Museum	$7.50		$
Dinner at Wyoming Territorial Park Please indicate your preference and # of meals: Prime Rib _______ Chicken Cordon Bleu _______	$20.00		$
Breakfast at American Heritage Center	$8.00		$
Lunch at Medicine Bow	$7.50		$
Dinner at Rawlins Jeffrey Center	$16.00		$
Breakfast at Rawlins Jeffrey Center	$5.00		$
Total Conference Activity/Meal Fees			$

Please register by June 1, 2008 or earlier if possible. Registrations after June 1 must add 10% to the amounts listed below. Mail completed form (or copy) along with check for total amount to:

Uinta County Historical Society

P.O. Box 184

Lyman, WY 82937