1 minute read
Conference Registration Form
ASSOCIATION OF ARKANSAS COUNTIES 51st ANNUAL CONFERENCE HOTSPRINGSCONVENTIONCENTER GARLAND COUNTY, ARKANSAS August 21‐23, 2019
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
