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March 19-23, 2012
Okemos Conference Center, 2187 University Park Drive, Okemos, MI 44864 |
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Note: if you do not want to register online, get the PDF registration form here: Mail-in Registration form  |
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| First Name * |
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| Last Name * |
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| Informal Name |
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| Agency |
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| Mailing Address * |
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| City * |
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| State |
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| Zip |
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| Phone |
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| MCOLES Number |
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| Email * |
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Registration |
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| Fees: |
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| Total Charge: $ |
0.00 |
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Please enter the Name as it appears on the credit card you will be using. If it is different than yours, this will help us match this registration to the PayPal transaction: |
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| Name on Credit Card |
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| Please enter this code: |
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Clicking Submit will direct you to the PayPal site to make payment. You can use your PayPal account if you have one, or use your credit or debit card. |
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