TOP DOG-06 WORKSHOPS

January 27-29, 2006

Howard Johnson Riverfront

250 Spring Street

Charleston, S.C. 29403

Registration Form

Print, fill out and send in monies to

Dixieland Guide Dog Users

802 Castle Avenue

Charleston, SC 29407

_____Yes! I plan to attend your REGIONAL TOP DOG-06 WORKSHOPS! I understand that the registration fees are $50 per person and include all meals on Saturday, January 28, 2006 and a continental breakfast on Sunday,

January 29, 2006.

_____No. Not this year. But here’s my monetary gift to help curtail the cost for someone else to go! Please add my name to the program as a donating sponsor. I look forward in reading Dixieland’s newletter.

I further understand that I must make my hotel reservations directly through HOWARD JOHNSON RIVERFRONT (843-722-4000) to take advantage of their special $45 per night room rate.

Name:_______________________Guide‘s Name:_________

Address: _____________________________

City: ___________State:_______Zip:_____

Telephone: ___________(Home) __________(Cell)

Email: _______________

Program format: Braille/Large Print:_______________

Optional 90 Minute Bus Tour

Yes! I want to take advantage of the special 90 minute bus tour of downtown Charleston on Saturday, January 28, 2006. I understand the additional cost for this tour is $20 per person and have included it with my registration check/money order.

$50 Registration fees per person (if made prior to 11/30/05)

$55 After 11/30/05

$20 Optional Bus tour per person (if made prior to 11/30/05)

$25 After 11/30/05

$ _____ Total amount sent

Please send your registration form with your check/money order to:

Dixieland Guide Dog Users

802 Castle Avenue

Charleston, SC 29407

Any questions or comments Call Audrey Gunter (843-571-0737)

Note:

We plan to have some sighted volunteers to offer complimentary transportation to and from the Charleston International Airport. It is understood that this service is on an “available” basis and not guaranteed. Just call, write or email me your flight information before January 15, 2006, and we will try to schedule you. The airport is approximately 15 miles from HoJo's and taxi cabs are also available at an approximate cost of $20 each way.

Cancellation Policy:

A full refund will be made to anyone who must cancel before January 1, 2006. After that date a $25 administrative fee will be charged. There will be no refunds given if cancellation is made after January 15, 2006.