2008 FCCMH and FLAPRA Conference Registration Form

Discounted registration fees are offered for groups of 6 or more. If you would like to register a group, please use this form.

Please complete the form below and click the submit button.

Title:
First Name:
Last Name:
Badge Name:
Business Title:
Organization:
Address:
City:
State:
Zip Code:
Email:
Please enter an email address that reaches you directly.
Phone:
Fax:

FULL CONFERENCE REGISTRATION FEES
Save $$$ - conference prices increase after August 15, 2008!
Includes 2 1/2 Day Conference September 8 - 10, 2008

$195 Member
$245 Non-Member


ONE DAY REGISTRATION FEES

Monday, September 8 Only
$165 Member
$205 Non-Member

Tuesday, September 9 Only
$165 Member
$205 Non-Member


TWO DAY REGISTRATION FEES

Monday and Tuesday (September 8 - 9) Only
$185 Member
$235 Non-Member

Tuesday and Wednesday (September 9 - 10) Only
$185 Member
$235 Non-Member


WEDNESDAY ONLY REGISTRATION FEES

$95 Member
$145 Non-Member


I plan to attend the awards breakfast on Tuesday, September 9
Yes
No


CONFERENCE SESSIONS

Please indicate which sessions you are interested in attending on those days for which you're registering.

Monday, September 8 (If applicable):
9:45 am - 11:45 am

1:00 pm - 3:00 pm

3:30 pm - 5:30 pm


Tuesday, September 9 (If applicable):
9:45 am - 11:45 am

1:00 pm - 3:00 pm

3:30 pm - 5:30 pm


Wednesday, September 10 (If applicable):
10:00 am - 12:00 pm


PAYMENT INFORMATION

Please let us know how you prefer to pay for your conference registration:
Check or Purchase Order
Credit Card