AHFSA ANNUAL CONFERENCE REGISTRATION

Nashville, Tennessee

 September 20-22, 2010

Meeting Fees: $550 each for the first two state agency registrants and $300 for each additional state agency registrant.
  No partial registration fee will be accepted.

$600 for each private sector registrant. 

Additional meals may be purchased for each guest not attending the meeting for a cost of:
Sunday reception $25 - Monday lunch $25 - Tuesday Awards luncheon $35.      

 1st Name    
 2nd Name  
 3rd Name   
 4th Name  

Address     
City              
State & ZIP Code

Phone         
E-Mail       

                                                                                                                                                    Number                Total
Item Description Dates         Attending   1 2 3 4 5 6 7 8 9 10 Amount 
                                                                                                                                  
Method of Payment: Check in Process   Invoice Requested  Pay at Meeting (Receipts are available at the meeting)

Federal ID Number 39-1531391

AHFSA
1505 Solemn Grove Rd
Garner, NC 27529
919 661-8774
rgoodnow@bellsouth.net