All scholarships from the OMNOVA Foundation have been awarded to the first five qualified applicants.

 

Complete one form per attendee. Attendees must agree to attend all three sessions.

Directions: Tab and type to complete this page. Print it. Push the [Submit] button to start the reservation process.

• If you are paying by check: Mail this completed form with your check to Info Line, 703 South Main Street #211, Akron OH  44311.
• If you are paying by MasterCard or Visa: Fax this completed form with your credit card information to 330-315-0399.
• Payments will be accepted at the door, although we encourage you to pay early to avoid long lines at the event.

Attendance is limited to the first 30 registrations. If you make a reservation, you are responsible for the fee even if you do not attend. Cancellations must be received by October 15.

Questions? Phone: 330-315-1335   Live Help: www.pclivehelp.org

Name
Organization
Address
City, State, Zip
Daytime Phone Number
E-Mail Address (required)
Does your organization have an operating budget of $500,000 or less?	Yes  No
Do you want to apply for the scholarship offered by the OMNOVA Foundation?	Yes  No
Total amount you will pay:	$
Payment option: If you are paying by check: Mail this completed form with your check to Info Line, 703 South Main Street #211, Akron OH  44311. If you are paying by MasterCard or Visa: Print this form, write down your credit card information, and fax this completed form 330-315-0399.	Check enclosed Charge my credit card:  __ Visa         __ Mastercard        Will appear as “INFO LINE” on your statement Number _____________________________ Exp _________ Signature _______________________Security Code______
Questions for the speaker: