Registration for: Annual Training Conference - June 27-30, 2010 Contact Information: Fields with * are required: *Name: *MCOLES number: *Title: *Department: Mailing Address: *City: *State: *Zip: County: *Phone: Fax: Email: Spouse Name: (note: a FULL registration INCLUDES one Boxed Lunch Ticket (Monday) and one Banquet Ticket (Tuesday) - additional tickets for spouse or guest are extra; see below)
Full Registration: Member $245 Life Member $120 Non-member $295 Meal Tickets: (note: banquet tickets are non-refundable) Extra Tickets for Monday Boxed Lunch $15 each Extra Tickets for Tuesday Awards Banquet $35 each Partial Registration: You may register for any number of half-day sessions: Monday PM only $80 Tuesday AM only $80 Tuesday PM only $80 Wednesday AM only $80 Amount Charged: Card Type: VISAMasterCard Name on Card: Card Number: Expiration Date: JanFebMarAprMayJunJulAugSepOctNovDec / 2009201020112012201320142015 CW2:  (3 digit code on back of card)