How many people are you registering? * 1 2 3 (including yourself) Fill in your registration information on this page. You will be able to enter the registration information for additional people after you complete this page and click "Continue". Event Registration First Name * Last Name * Email Address * Phone * Street Address * City * State * - select State/Province - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Postal Code * Event Fee(s) Complete Super Early Bird $ 150.00 Student Super Early Bird $ 125.00 A la Carte Friday Night Event - $ 50.00 Saturday Training - $ 100.00 Saturday Dinner - $ 100.00 1994 Society Breakfast (non-member) - $ 65.00 Delegate (free business meeting) - $ 0.00 Total for this participant Election law requires us to use our best efforts to collect and report the name, mailing address, occupation and the name of the employer of individuals whose contributions exceed $200 in a calendar year. If you are currently not working, you may enter “Retired” or “Not Employed”. Political contributions are not tax-deductible.Employment Information Employer Occupation Register
