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Attendee Registration
First Name
*
Last Name
*
Title
*
Municipality/Organization
*
(Choose One)
City of
Village of
Private Sector
Address
*
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State
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AA
AE
AP
Email
*
Phone Number
*
Guest/Spouse Full Name
Changed name or municipality in the past year?
(Choose One)
Yes
No
Dietary Needs
Registration Rates
Registration Options
*
Full Program Rates - Early Bird Available until September 24
One Day Program Rates - Early Bird Available until September 24
Full Program Rates
*
Member City/Village ($325.00)
First-Time Attendee City/Village ($230.00)
Non-Member Municipality ($535.00)
Other Company/Organization ($585.00)
Meal Options
Choose One
*
Do not need to purchase meals (Staying at Holiday Inn - Host Hotel)
Need to purchase meals (Commuting or other accommodations)
Not participating in meal functions
Total
$325.00
Payment Options
Public Works School Payment
*
(Choose One)
Voucher
Check
Credit Card
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Event Registration Software by RegFox
