2012 conference form

NAME:

TITLE:

ORGANIZATION:

ADDRESS:

CITY:

STATE:

ZIP:

PHONE:

FAX:

EMAIL:

PLEASE INDICATE WHICH EVENTS YOU WILL ATTEND:

Attendance Registration Fees:

Conference (Two Days) $175

Thursday (One Day Only) $125

Friday (One Day Only) $125

Friday (Trade Show/Luncheon Only) $50

Friday (Maintenance Only) $125

Registration Fees - Total Amount Due

Vendor Registration Fees:

$300

Note: Display cost of 8’ table to showcase your materials during the Conference and attend all conference meals and educational sessions.

Vendor Fees - Total Amount Due $300

Sponsorship Opportunities Available

$100 $500 $1000

If you would like to pay using a credit card, contact Judith Fleming using the information below.

If you would like to mail the completed form with payment, click here to download the pdf file.