Annual Hunter Education Instructor Conference Registration
 (Print this page, fill out and mail)

Name:______________________________________________________________________

Instructor ID#:_______________________________________________________________

Address:____________________________________________________________________

City:______________________________________  State:________  Zip:_______________

E-Mail _____________________________________________________________________

I will be attending the Conference on Friday and Saturday night Banquet _____Yes _____No

Number of attendees ___ X ($20.00 ea.) or ____ X ($30.00 per couple) = Total ____________

List names of attendees for badges (spell names as you wish them to appear)
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______________________________________________________________________________________
______________________________________________________________________________________
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Make checks payable to THEIA

Return form with check or money order by  February 15, 2009 to:

Donnie Kee, Treasurer
3802 S. Medford Dr
Lufkin, Texas 75901