EmailMe Form - AFSS Educational Forum 2016

Name *

First Last

Agency or Department *

Job Title or Rank *

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Email *

Phone *

### - ### - ####

AFSS Member *

Educational Forum Registration

Select registration type: *

AFSS Member: $300

AFSS Life / Retired Member: $200

Guest / Non-Member: $350

LATE (after 4-1-16): $400

Single Day: $150

LATE Single Day (after 4-1-16): $250

Installation Banquet 4-28-16: $70 (for Single Day or Guests only - Banquet is included for those registering for full Educational Forum

Payment will be made: *

by PayPal (service fee is included) Please see PayPal URLs below.

by mailing check by 4-1-16 (payable to AFSS North) to PO Box 2852, Truckee, CA 96160

Meals

Full Registration fees include lunch on Wednesday and Thursday, and dinner at the Installation Banquet on Thursday evening.

Dietary Needs
Please check all that apply *

No dietary restrictions

Vegetarian

Gluten-free

Other

If this will be your first AFSS Educational Forum/Conference, please check the box below.

This is my first AFSS Conference

If you are paying by credit card, please use the appropriate PayPal URL below:

Full Registration - AFSS Member
http://tinyurl.com/2016Full

Full Registration - AFSS Life / Retired Member
http://tinyurl.com/2016LifeMember

Full Registration - Guest / Non-Member
http://tinyurl.com/2016FullGuest

LATE Full Registration
http://tinyurl.com/2016Late

Single Day
http://tinyurl.com/2016SingleDay

LATE Single Day
http://tinyurl.com/2016LateSingleDay

Installation Banquet
http://tinyurl.com/2016Banquet