PMAA 80th Annual Conference & Trade Show Registration Form

Emergency Contact Information

• * Please provide an emergency contact name and phone number

Registrant

• * First Name:
• * Last Name:
• Nickname:
• * Job Title
• * Email Address:
• * Confirm Email Address:
• Guest Name (no registration fee):

• Fee

  Type	Fee
  Registration Fee	$345.00
  Exhibitor - Choose this option if already registered as an exhibitor	No Charge
  Banquet Only - Choose this option if you are attending the Banquet ONLY.	No Charge

Authority or Firm Information

• * Company:
• * Address 1:
• Address 2:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:
• * Phone:
• Fax:

• CANCELLATION POLICY: Full amount of conference registration/fees for ticketed events will be refunded if written cancellation notice is received by PMAA no later than Friday, July 29. After this date, a $50.00 charge will be assessed to cover handling costs on registration cancellations and a 10% charge will be applied to ticketed function cancellations. Refunds will be issued in the same manner in which paid. Due to count guarantees, no refunds will be issued after Monday, August 8. If you have any questions, please contact Kim Wenrich via email at wenrich@municipalauthorities.org. By clicking "Register", you agree to the terms of the Cancellation Policy.

• EDUCATIONAL SESSIONS: Please indicate the educational sessions, listed below, you may attend (tentative only) to assist in adequately selecting meeting rooms. Continuing education credits are noted where available. See the Conference Brochure for full descriptions of the educational sessions.