VBODA 1

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Please fill out the form below with your financial information, student name corrections (if they are incorrect on the results spreadsheet), MENC Card number and expiration date and submit to me ASAP. Check should be made out to Deep Run High School and sent to the address below:

Jaraun M. Ransome
Deep Run High School
4801 Twin Hickory Road
Glen Allen, Virginia 23059

Important: deadline for registration form is Thursday, January 22, 2009 and payment postmark due date is Monday, January 26, 2009!

If you have students who are not participating, please send an email to me at jmransome@henrico.k12.va.us immediately so that other students may be notified. If registration and/or payment is not received by the above due dates, you will forfit your opportunity to participate in this District-1 event.

If you have any questions, or need further assistance, please do not hesitate to contact me at 804-364-8000 or email me at jmransome@henrico.k12.va.us.

(* required fields)

* School:

* Address/City/Zip:

* email

Director names

* Name: * Phone:

*Menc #: *Exp. Date:

Name: Phone:

Menc #: Exp. Date:

Name: Phone:

Menc #: Exp. Date:

* Enclosed are Student fees
@ $16.00 each. * Total $

* Director meals # @ $8.00 each. Total $

Don't forget to add the VBODA event fee - $5.00

Non-member fee if applicable ($102) $

* Total amount due: $

Student name corrections:


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You are here: Home: Please fill out the form below with your financial information, student name corrections (if they are incorrect on the results spreadsheet), MENC Card number and expiration date and submit to me ASAP. Check should be made out to Deep Run High School and sent to the address below: Jaraun M. Ransome Deep Run High School 4801 Twin Hickory Road Glen Allen, Virginia 23059 Important: deadline for registration form is Thursday, January 22, 2009 and payment postmark due date is Monday, January 26, 2009! If you have students who are not participating, please send an email to me at jmransome@henrico.k12.va.us immediately so that other students may be notified. If registration and/or payment is not received by the above due dates, you will forfit your opportunity to participate in this District-1 event. If you have any questions, or need further assistance, please do not hesitate to contact me at 804-364-8000 or email me at jmransome@henrico.k12.va.us. (* required fields) * School: * Address/City/Zip: * email Director names * Name: * Phone: Menc #: Exp. Date: Name: Phone: Menc #: Exp. Date: Name: Phone: Menc #: Exp. Date: * Enclosed are Student fees @ $16.00 each. * Total $ * Director meals # @ $8.00 each. Total $ Don't forget to add the VBODA event fee - $5.00 Non-member fee if applicable ($102) $ * Total amount due: $ Student name corrections: