Page 9 - CONF 2016 Vol 34 No 4
P. 9
2016 TCAPWA & SWANA
Annual Joint Conference
Memphis (Nov. 8-10, 2016)
Registration Form
Company Name _______________________________________________ Contact ____________________________
Address _________________________________________________________________________________________
City _____________________________________________State __________________ Zip _____________________
Telephone ______________________ Email ___________________________________________________________
AGENCY AFFILIATION (check all that apply): __ TCAPWA __ SWANA __ Young Professional (35 and under)
ADVANCED FULL Registration (Must be RECEIVED on or before October 14)
Includes: Wednesday Rodeo Lunch and Branch Reception, and Member _____@ $295.00 __________
Thurs. Breakfast, Lunch, Technical Sessions, and Closing Event/Dinner ticket _____@ $325.00 __________
___ Number of people attending Closing Event/Dinner (included in registration) _____@ $325.00 __________
_____@ $355.00 __________
Non-member
_____@ $195.00 __________
ON-SITE FULL Registration (If RECEIVED after October 14)
Includes: Wednesday Rodeo Lunch and Branch Reception, and Member
Thurs. Breakfast, Lunch, Technical Sessions, and Closing Event/Dinner ticket
___ Number of people attending Closing Event/Dinner (included in registration) Non-member
One-Day Registration
Includes: Thursday Breakfast, Lunch, Technical Sessions
Member
Non-member _____@ $225.00 __________
Closing Night Event/Dinner Ticket Only (not including full registrants) _____@ $50.00 __________
Spouse/Guest Registration _____@ $100.00 __________
Includes: Wednesday Rodeo Lunch and Branch Reception, and
Thursday Breakfast, Lunch, Technical Sessions, and Closing Event/Dinner ticket
___ Check if attending Closing Event/Dinner (included in registration fee)
Rodeo Registration (Wednesday, Nov. 9)
Rodeo - Individual Entry _____@ $25.00 __________
Includes: Wednesday Rodeo Lunch and Branch Reception
Rodeo - Team (more than 10) Entry _____@ $250.00 __________
Includes: Wednesday Rodeo Lunch and Branch Reception for each entry
ATTACH A LIST OF NAMES
Golf Registration (Tuesday, Nov. 8) ______@ $50.00 __________
Individual Entry at the Links at Galloway Golf Course
8am shotgun start (Includes: Tuesday Lunch)
Total Amount Enclosed $ _________________
Number attending 1916 Gayoso Pump Station Tour on Nov. 8th at 1pm: ________
Event Hotel: Sheraton Memphis Downtown, (901) 527-7300. Use code “2K05AA” when making reservations. Conference rate ($129)
is available until October 11, 2016. For additional information call Mark Miller at (865) 850-1534 or email markmiller@charter.net.
Make checks payable to TCAPWA and mail to Mark Miller, PO Box 1350, Pigeon Forge, TN 37868 or register online at
Tennessee.apwa.net. NO INVOICES will be issued for fees.
TCAPWA & SWANA Thank You For Your Support!
Annual Joint Conference
Memphis (Nov. 8-10, 2016)
Registration Form
Company Name _______________________________________________ Contact ____________________________
Address _________________________________________________________________________________________
City _____________________________________________State __________________ Zip _____________________
Telephone ______________________ Email ___________________________________________________________
AGENCY AFFILIATION (check all that apply): __ TCAPWA __ SWANA __ Young Professional (35 and under)
ADVANCED FULL Registration (Must be RECEIVED on or before October 14)
Includes: Wednesday Rodeo Lunch and Branch Reception, and Member _____@ $295.00 __________
Thurs. Breakfast, Lunch, Technical Sessions, and Closing Event/Dinner ticket _____@ $325.00 __________
___ Number of people attending Closing Event/Dinner (included in registration) _____@ $325.00 __________
_____@ $355.00 __________
Non-member
_____@ $195.00 __________
ON-SITE FULL Registration (If RECEIVED after October 14)
Includes: Wednesday Rodeo Lunch and Branch Reception, and Member
Thurs. Breakfast, Lunch, Technical Sessions, and Closing Event/Dinner ticket
___ Number of people attending Closing Event/Dinner (included in registration) Non-member
One-Day Registration
Includes: Thursday Breakfast, Lunch, Technical Sessions
Member
Non-member _____@ $225.00 __________
Closing Night Event/Dinner Ticket Only (not including full registrants) _____@ $50.00 __________
Spouse/Guest Registration _____@ $100.00 __________
Includes: Wednesday Rodeo Lunch and Branch Reception, and
Thursday Breakfast, Lunch, Technical Sessions, and Closing Event/Dinner ticket
___ Check if attending Closing Event/Dinner (included in registration fee)
Rodeo Registration (Wednesday, Nov. 9)
Rodeo - Individual Entry _____@ $25.00 __________
Includes: Wednesday Rodeo Lunch and Branch Reception
Rodeo - Team (more than 10) Entry _____@ $250.00 __________
Includes: Wednesday Rodeo Lunch and Branch Reception for each entry
ATTACH A LIST OF NAMES
Golf Registration (Tuesday, Nov. 8) ______@ $50.00 __________
Individual Entry at the Links at Galloway Golf Course
8am shotgun start (Includes: Tuesday Lunch)
Total Amount Enclosed $ _________________
Number attending 1916 Gayoso Pump Station Tour on Nov. 8th at 1pm: ________
Event Hotel: Sheraton Memphis Downtown, (901) 527-7300. Use code “2K05AA” when making reservations. Conference rate ($129)
is available until October 11, 2016. For additional information call Mark Miller at (865) 850-1534 or email markmiller@charter.net.
Make checks payable to TCAPWA and mail to Mark Miller, PO Box 1350, Pigeon Forge, TN 37868 or register online at
Tennessee.apwa.net. NO INVOICES will be issued for fees.
TCAPWA & SWANA Thank You For Your Support!
