SRPLN || Southern Program Leadership Development

2009 SR-PLN, AEA & ASRED Joint Meeting - Registration

Online Registration Form

Download Printable Version [PDF]
Title:	First Name (Preferred):	Last Name:

Position:	Organization:

Address:

City:	State:	Zip Code:

Contact Name	Contact E-mail:

Participant E-mail:

Phone:	Fax:

Which of the following will you be Attending?
	Please view table below for pricing information.
I will be participating in the Urban Task Force Pre-Conference Roundtable (Mon. 8/24 - Free) Yes No

Please select your primary committee:

Conference	Double Early Bird Price (By June 30th)	Early Bird Price (By August 1st)	Late Price (After August 1st)
PLN Meeting	$275	$300	$325
AEA/ASRED	$275	$300	$325
PLN & AEA/ASRED	$350	$375	$400

Are you a first-time attender of the Joint Meeting?
If you are a first time attendee of the joint PLN Conference, please make plans to attend the Newcomer Orientation at 5:00 p.m. on Monday, August 24. Yes, This is my first time to attend the Joint Meeting. No, I have attended at least one Joint Meeting before.

Will you be bringing any guests?

Yes, I will be bringing guests.*
No, I have no guests joining me.

*-A fee of $75 will be charged per guest.

Please note that, in order to protect your information, the SRDC can no longer accept credit card information online. Please call the SRDC at 662.325.3207 (Fax: 662.325.8915) to give us your payment information.

Send checks to:
Southern Rural Development Center
Attn: Abbie Misso
Box 9656
190 Bost-North
Mississippi State, MS 39762