ASSOCIATION OF ARKANSAS COUNTIES
51 ANNUAL CONFERENCE HOT SPRINGS CONVENTION CENTER GARLAND COUNTY, ARKANSAS st
August 21‐23, 2019
PRE‐REGISTRATION DEADLINE IS WEDNESDAY, AUGUST 7TH PRE‐REGISTRATION ON‐SITE REGISTRATION Officials, Employees, and Guests $125.00 $145.00 Spouses $80.00 $100.00 Non‐Members $145.00 $165.00 PLEASE ONLY USE THIS FORM IF YOU PLAN TO PAY BY CHECK WE OFFER ONLINE REGISTRATION FOR THOSE PAYING BY CREDIT CARD ONLINE REGISTRATION – WWW.ARCOUNTIES.ORG
PLEASE FILL OUT A SEPARATE FORM FOR EACH COUNTY EMPLOYEE YOU MAY COPY THIS FORM – INCOMPLETE FORMS WILL NOT BE PROCESSED
PLEASE PRINT CLEARLY
NAME
___________________________________________________________________
COUNTY
_________________________ TITLE ___________________________________
ADDRESS
___________________________________________________________________
CITY
_________________________ STATE ______________ ZIP _______________
E‐MAIL
___________________________________________________________________
SPOUSE / GUEST REGISTERING YES __________ NO __________
(Pre‐Registration ‐ $80 for Spouse / $125 for Guest)
SPOUSE / GUEST NAME _____________________________________________ (Non‐County Employee)
AMOUNT ENCLOSED: __________ (Make Check Payable to: Association of Arkansas Counties) CONFERENCE REGISTRATION FEES MUST ACCOMPANY THIS FORM BEFORE REGISTRATION CAN BE PROCESSED REFUND POLICY: Notify AAC Office before 4:30 PM on Wednesday, August 7th to Receive Refund of Conference Registration Fees – NO Refunds will be Issued After August 7th
COMPLETE REGISTRATION AND MAIL WITH PAYMENT TO: Association of Arkansas Counties • 1415 West Third Street • Little Rock, AR 72201 or E‐Mail to abaker@arcounties.org For registration questions please call: (501) 372‐7550
