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Louisville, Kentucky September 14-17, 2004


Conference On-Line Registration

Registration Directions:
This form is for general attendance registration only. If you are an exhibitor or sponsor, please click HERE for additional information and your registration process.

Conference Registration: $0

Guest Evening Event Passes:
Regular: $150 (if payment postmarked after August 6, 2004)

Hotel Registration: Contact the hotel to reserve your room today! The conference rate for guest rooms is $102.00 per night (plus 13.95% tax). This group rate is extended two days prior and two days after conference based on availability. Rate cutoff date: August 6, 2004.

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 Vicki Hall at (502) 564-2900 or DeDe Conner at 502-564-2367 or email at naswa2004@ky.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 *
Confirm Email address *

Special Accommodations

Guest Information
Guest Fees for each guest (evening events only) $150
Total Number of Guests:
Guest Name(s): - List names separated by commas
Event Information
Please check the events you plan to attend; enter number of optional guest(s) who plan to attend each event:
  Registrant Guest(s)
Tuesday, September 14
2004 Executive Board Meeting
Tuesday, September 14
Welcome Reception
Wednesday, September 15
Kentucky Derby Museum Dinner
Thursday, September 16
Louisville Slugger Reception
Payment Information:
Purchase Order:   Purchase Order #:  
Registration Fee mailed under separate cover:
Please Note: Any guest fees MUST be postmarked by the cutoff date to qualify for that fee.
Federal ID #: 52-0978073

 
 
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