<p> DISTRICT 11 A-1 CONVENTION REGISTRATION Embassy Suites by Hilton 850 Tower Dr, Troy, MI, 48098 APRIL 21-23 2017 Please use one sheet for each person in your group/family!</p><p>Name______*Guest______Lion___Lioness ___Leo___</p><p>*If you are a guest please note who you are the guest of ______</p><p>Club______District______</p><p>Address______City______</p><p>Zip______Phone ______Cell ______</p><p>E-Mail Address______</p><p>Please indicate highest Lions Office held ______</p><p>Current President___ Incoming President___ New Member___</p><p> Is an American Sign Language Interpreter needed? Yes No (Please circle)  Are wheelchair seating/accommodations needed? Yes No (Please circle) NEW MEMBER REGISTRATION FEE (became a member after April 1, 2017) $ NO COST - 0</p><p>Registration Fee For LIONS in District ($10.00) $______NOTE: If you do not attend convention and only come to vote you must pay this fee </p><p>Registration Fee (NON-LIONS/GUESTS, ($10.00) $______</p><p>Saturday Banquet $30.00 each ___ chicken ____Beef ___ Vegetarian $______</p><p>Extra Donation towards the convention (this is opt) $______</p><p>Saturday Cabinet/Business Meeting (are you attending) ______check off Sunday Elections (No cost -Please RSVP your attendance) _____ check off Friday evening Meet Mix and Mingle (Membership-Fellowship ) ______check off </p><p>Total Enclosed Deadline on or before April 15th $______Make Check Payable to: District 11 A-1 Mail form and full payment to: Lion Shirley Kelly 19712 Cheyenne Detroit, MI 48235</p><p>For additional information please contact Lion Shirley Kelly at 313-706-9902 or by email at [email protected] Deadline On/Before April 15, 2017. Postmarks of April 15th will be accepted!</p>