May Day Convention Registration

May 1st thru May 4th 2008

One Form per person please.

Name:__________________________________________________

Title:   __________________________________________________

Company: _______________________________________________

Address:________________________________________________

City:______________________ State:____________ Zip:__________

Phone:____ ____ _____

Email:____________@______________________

Registration Fees

Check all that apply

Registration $295.00:_________________(Includes 1yr OCSA Membership + 3 days lunches)

Additonal Person $175.00:____________________
(Same company)

Registration $195:___________________________
(One day only, includes lunch)

OCSA Certification Test $150.00:_______________

Table at Trade Show $250.00__________________

Total Enclosed $_____________________

Make checks payable to Oregon Chimney Sweep Association

Send to: OCSA c/o
               Grants Darrow
               72065 Darr Rd.
               Elgin, OR 97827