25th Annual CUMSA Conference

 Register Online Today

*Registration approval will be confirmed within 24 hours through email. Registration approval shall be used as the invoice for check writing requirements.

     $199  (Early Registration until March 1, 2012 / $225  March  2- 15, 2012)

 includes Meals, Conference Sessions & Banquet

  $75 Special One-Day Rate  /  Attending  the conference Monday March 19^th   includes Meal , Conference Sessions

Payment must be received no later than March 15, 2012 to reserve attendance.

Participant Name
Title
Institution
Mail Address
City
State	Select a State Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missourri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip code
E-mail
Phone
Fax

   $99 Discount  /  Add  one additional conference participate at discount registration from my Institution 

 includes Meals, Conference Sessions & Banquet

Participant Name
Title
E-mail

  No Banquet Guest One Banquet Guest $45 Two Banquet Guest $90 Three Banquet Guest $120 Four Banquet Guest $160 /  Annual CUMSA Banquet  includes Banquet only

 

(Payment must be received by no later than March 15, 2012)

 Credit Card payments for CUMSA Conference

*Confirmation of registration form will be sent to the email address

provided above upon submission of this form.