Fall District Conference Oct 27-30, 2022 at Woodloch Pines Resort 731 Welcome Lake Rd., Hawley, PA 18428
Registration Now OPEN!
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Rotarian's First Name,  Last Name and Middle Initial *
Club Name *
Student's First Name, Last Name, Middle Initial (Please  Type "N/A" if You are not a  Student)
 *
Student's Rotary Youth Program: (select one) *
Enter Your Badge Ribbon Selection Below. (Please enter all that apply for you & your partner please indicate if you need more than one)
Leadership: DG DGE DGN DGND PDG DRFC AG DT DS President Pres.-Elect Past President.
District Committees: Foundation Conference Rotaract YEP RYLA Interact PR/Marketing Gift of Life.
Foundation Recognition: Paul Harris Fellow PHS Major Donor AKS Benefactor Bequest Society
Interact Student
RYLA Student
Youth Exchange Student
Badge Ribbon Selection *
Mailing Address with City, State and ZIP *
Email *
Cell Phone *
Home Phone
Please select Your 4-Day Conference Package *
Required
Will you like to take Round Trip Bus Fare $100 Per Person? (Students  are  Exempt From This) *
Please list all names of people needing Round Trip Bus Fare.  (If you are a Student please Type " I am a Student and I am  Exempt From This)
Above Conference package includes 3 nights lodging, Thursday Welcome Dinner, Friday & Saturday Breakfast, Governors Banquet on Friday Night, Murder Mystery Dinner on Saturday Night & Sunday Brunch.
Dietary restrictions *
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