Rally at the Capitol

September 10, 2009

Space is limited! Please fill out one registration form for each person attending.
	Departing from Farmington Hills, MI I will attend and would like to reserve a space on the bus leaving from Gale at 27500 Drake Rd. in Farmington Hills, MI, 48331 at 7:00 a.m. (Snacks will be provided.)
	Departing from Gaylord, MI I will attend and would like to reserve a space on the bus leaving from Otsego County Library at 700 S. Otsego Ave. in Gaylord, MI, 49735 at 5:30 a.m. (Snacks will be provided. One rest stop each way.)

	* Required information
Participant Name*
Library/School/ Institution Name*
Interest in Event*
Address*

City*
State/Province*
ZIP/Postal Code*
Phone
E-mail*
Emergency Contact Information
Name*
Relationship*
Phone*
City*

If you have special needs please contact Beth Hoffman at Beth.Hoffman@cengage.com.