Overview > Conference Proceedings > 2012 SR-PLN, AEA & ASRED Joint Meeting

2012 SR-PLN, AEA & ASRED Joint Meeting

2012 Meeting
Online Registration Form

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

Address:
City: State: Zip Code:
 
Administrative Contact Name Administrative 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 Activities at 1:30-4:30 p.m. on Monday, August 20.
Yes
No
Please select your primary committee:

Social Media Break-Out Sessions - Please select one:

Cross-Committee Topics - Please select the one you plan to attend:

Conference
Early Bird Price
(By July 15)
Late Price
(After July 15)
PLN Meeting
$325
$350
AEA/ASRED
$325
$350
PLN & AEA/ASRED
$400
$425
* Payment & Registration must be received by July 15 to be eligible for the Early Bird Price.

Are you a first-time attender of the Joint Meeting?




Will you be bringing any guests?

guests.*

* A fee of $100 will be charged per guest.

* You may transfer your conference registration to another person within your organization by August 10, by notifying Vicki Vaughn by email vickiv@srdc.msstate.edu . If you must cancel, please notify Vicki by email by August 10 at which time a refund for the registration amount, less a $50 cancellation fee, will be processed. Cancellations made after August 10 as well as no-shows are liable for the full registration fee.

* Registration and Payment must be received by July 15 to be eligible for the Early Bird Discount.

Please note that, in order to protect your information, the SRDC can no longer accept credit card information online. Please call Victoria Mayhall at 662.325.3207 or Vicki Vaughn at 662.325.1775 to give us your credit card payment information.

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



 

 

 

 

 

For Questions or Comments, contact Albert Hart.