AIDS 101 Registration Form
Please complete the following:

Which of the following seminars do you plan to attend in 2008?

January 26th
Clayton State University
2000 Clayton State Blvd
Morrow, GA 30260
March 29th
Hillcrest Church of Christ
1939 Snapfinger Rd
Decatur, GA 30035
June 14th
Clayton State University
2000 Clayton State Blvd
Morrow, GA 30260
August 23rd
Harmony Grove United Methodist Church
50 Harmony Grove Road
Lilburn, GA 30047
November 8th
TBA

Contact Information:

Name:       

Address:   
City:            
State:         
Zip:             
Home Phone:  
Work Phone:    

Additional Information:
I prefer a vegetarian lunch.
I am disabled and require special services. Please write a description of your needs.

How did you hear about AIDS 101? (please write in the box below):

Fees and Payment Information:
Summary of Fees
Standard Fee
Participant, preregistered
$20
Student/Senior
$10
Repeating AIDS 101
$10

You may register over the phone a few days prior to the seminar. Otherwise, please mail in your registration.

Please do not send cash. Make checks or money orders payable to AID Atlanta.
I am enclosing a Check for $ . (Check fees above)
I am enclosing a Money Order for $ . (Check fees above)
I am repeating AIDS 101. The last date I attended was  
($10 donation for lunch suggested)

Again, thanks for your interest in AIDS 101, and we look forward to seeing you soon! Please check out the sample AIDS 101 agenda at this Web site.