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2016 WSC Registration Winter Conf (1) .pdf


Original filename: 2016 WSC Registration Winter Conf (1).pdf
Title: 2016 Registration Winter Conf

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AMAA Western States Regional Meeting
hosted by CMA ALLIANCE 

Registration Form deadline January 15, 2016

Friday pm, Saturday & Sunday am ~ Jan. 29-31, 2016
Name ______________________________

County _________________________________


Address ____________________________
____________________________

County/State Position/s ___________________

_______________________________________


Telephone (H) _______________________

(C) ____________________________________






Email ______________________________



Alliance Member – Full Registration

includes Friday- light dinner, Saturday- breakfast, lunch; Sunday- brunch
___ Yes, I will attend.
$195.00
___ Vegetarian meal selections

___ List food allergies ___________ __________ ___________


Special Saturday night dinner (optional)

___ Bandar Restaurant in Gaslamp District (5 minute walk)

$ 38.00

Alliance Member – Saturday only registration (with breakfast/lunch)

____ Yes, I will attend Saturday only.
$150.00
Spouse/Guest Information
____ Yes, my spouse/guest would like to attend the meals, please contact Sharon De St. Jeor

Payment

____ Check, payable to CMAA or
____ Credit card + $5.00 Visa or MC _________ card number ________________________________

expiration date _________________
security number ____________

TOTAL PAYMENT $ ____________

Mail form to: CMA Alliance, PO Box 12605, Bakersfield, CA 93389-2605

Fax: 661/328-9372, or Email to Kathy Hughes - CMAAkathy@gmail.com

Questions, contact Sharon De St. Jeor - cmaa@me.com 

-------------------------------------------------------------------------------------------------------------------------


THE WESTGATE HOTEL
1055 Second Avenue
San Diego, California 92101 

Reservations: 800-522-1564 | 619-238-1818
Hotel Registration DEADLINE - December 28, 2015



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