| Fees before August 27, 1999 | Fees after August 27, 1999 |
| $24.00 without Lunch ___ | $28.00 without Lunch ___ |
| $26.00 with Lunch ___ | $30.00 with Lunch* ___ |
| NAME | _______________________________ |
| PHONE NO. | _______________________________ |
| ADDRESS | _______________________________ |
| CITY | _______________________________ |
| STATE | _______________________________ |
| ZIP | _______________________________ |