2006 NASWA LMI Directors Conference

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Conference On-Line Registration

Conference Fees:
Registration Fee: $0

Guest Tuesday Evening Reception: $25
Guest Wednesday Evening Event Pass (Café 42): $0
Guest fees will be collected at registration, but guests must be registered in advance. See below.

Hotel Registration:
The conference rate for guest rooms is $69 per night single occupancy, $10 for each additional person, plus 12.125% tax.
Contact hotel to reserve your room today! Rate cutoff date: September 19, 2006.

Conference Registration Form:
Please complete the following form. Once you have completed the information, you will get a printable electronic receipt that includes your registration information and instructs you on how to remit payment.

For registration questions or additional information please contact Al Crumby at 501-682-3198 or email at al.crumby@arkansas.gov. .

* - indicates field is required

Total Conference Fee(s) *

$ 0

First Name *

Last Name *

Agency/Organization *

Title *

Address Line 1 *

Address Line 2

City *

State *

Zip *

Phone *

Extension

Fax

Email address *

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Special Accommodations

Guest Information

Guest Fees

$25 - Tuesday Evening Reception
$40 - Wednesday evening Clinton library tour and dinner

Number of Guests

Guest Name(s)
(Separate by commas, required if bringing guest)

Event Information

Please check the events you and your optional guest plan to attend:

	Registrant	Number of Guests attending
Tuesday, October 10, 2006 Welcome Reception
Wednesday, October 11, 2006 Clinton Presidential Center
Please select entrees for Wednesday night meal at Café 42 for you and your optional guest (required if attending Wednesday night event):
	Registrant	# guest(s) for this choice
Slow Roasted Brisket
Roast Turkey Breast
Baked Ham
Friday, October 13, 2006 LMI Awards Program and Brunch

Payment Information:

Purchase Order:

Purchase Order #:

Registration Fee mailed under separate cover:

For registration questions or additional information please contact Al Crumby at 501-682-3198 or email at al.crumby@arkansas.gov