2010 Convention Registration Form

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					                                                                                                     ACA’s 71st Annual Convention & Expo • July 11-14, 2010
2010 Convention Registration Form                                                                       Gaylord National on the Potomac • Washington, D.C.

Complete one form per person. Complete as you would like your badge to appear.

First Name ________________________________________                               Last Name __________________________________________

Name for Badge ____________________________________                               Member Number _____________________________________

Company _________________________________________                                 Title _______________________________________________

Mailing Address __________________________________________________________________________________________

City _____________________________________________                                State ___________________                    ZIP/Postal Code ___________

Country __________________________________________                                E-mail (required) ______________________________________

Telephone ________________________________________                                Fax _______________________________________________

q This is my first ACA Convention.

ACA Convention Registration Fees
ACA Convention Registration                                                             Early Bird (By 5/14)       Regular (5/15-6/14)         Late (On/After 6/15)
• First Registrant (see information sheet for voting info)*                             q $ 776                    q $ 862                     q $ 949
• Additional Registrants (from same company & location)             Save 15%!           q $ 660                    q $ 733                     q $ 807
• Spouse/Guest (Meals ONLY) Name for badge _____________________                        q $ 589                    q $ 648                     q $ 713
• One-Day Registration (Circle the day you will attend)                                 q $ 466                    q $ 518                     q $ 569
  Sunday Monday Tuesday
• Nonmember – Full Convention Registration                                              q $ 1,164                  q $ 1,293                   q $ 1,423
• Nonmember – One-Day Registration (Circle the day you will attend)                     q $ 698                    q $ 776                     q $ 854
  Sunday Monday Tuesday

President’s Banquet: Tuesday, July 13
q Yes, I am attending the President’s Banquet.
q No, I will not be attending.
Any changes to this section must be made by June 28. The deadline to receive a ticket for this event is June 28.

Legislative Day: Wednesday, July 14
q Yes, I plan on attending Ask Doctor Debt Makes a House (and Senate) Call

FREE Campus ACA Seminar: Collection Floor Management: Sunday, July 11
q Register me. (Space is limited.)

                                                             Page 1 Total (transfer to page 2 to calculate total payment) $ ____________

ACA Political Action Committee (ACPAC) Authorization is hereby given to ACPAC to solicit voluntary contributions from my company’s
executive personnel for the year(s) indicated below. Authorization can be given to only one federal-level PAC affiliated with a trade association per calendar year.
Signing this form does not obligate any of my company’s executive personnel or me to contribute to ACPAC; it only means we are willing to receive ACPAC materials.
These authorizations expire on Dec. 31 of each year indicated.

2010 Signature of Officer_____________________________________                    Title ________________________               Date _______________________

2011 Signature of Officer_____________________________________                    Title ________________________               Date _______________________

*For purposes of voting, this person will be considered the First Person Delegate.

Mail or Fax Your Forms Today:                                                                     Questions? Contact Campus ACA at +1(952) 926-6547
ACA International Convention Department, P.O. Box 390106,                                         Go to
Minneapolis, MN 55439-0106 • Fax: +1(952) 922-6402                                                Or e-mail
                              Early-bird Registration Deadline: May 14, 2010
MAP (Members’ Attorney Program) Conference                                                           Early Bird (By 5/14)            Regular (5/15-6/14)             Late (On/After 6/15)
• MAP Conference Only (MAP members/sponsors only)                                                    q $ 776                         q $ 862                         q $ 949
• MAP Additional Registrants
  (MAP member from same company & location)                         Save 15%!                        q $ 660                         q $ 733                         q $ 807
• MAP Conference & ACA Convention (Discounted price to attend both events.)                          q $ 1,242                       q $ 1,379                       q $ 1,518
• MAP Conference & ACA Convention Additional Registrants            Save 15%!                        q $ 1,056                       q $ 1,172                       q $ 1,290
  (From same company & location)
• ACA member but not a MAP member/sponsor                                                            q $ 961                         q $ 1,047                       q $ 1,134
q	Apply for CLE credits from my state. MUST register on or before May 7, 2010 to be eligible for CLE credits.
  Please write state(s)______________________________________.
q	Yes, I am attending the MAP special event on Monday, July 12.
• Buy-in for President’s Banquet. (Must be purchased by June 28, 2010.)                              q $ 135                         q $ 140                         q $ 145

PPMS (Professional Practices Management System) Seminar: July 9-10
• PPMS Seminar First Registrant – Member                                                             q $ 549                         q $ 549                         q $ 549
• PPMS Additional Registrant – Member                                                                q $ 469                         q $ 469                         q $ 469
• PPMS – Nonmember                                                                                   q $ 687                         q $ 687                         q $ 687
Number of employees in your company ___________

CCCO (Credit & Collection Compliance Officer) Workshop: July 10
• CCCO Workshop First Registrant – Member                                                            q $ 239                         q $ 239                         q $ 265
• CCCO Workshop Additional Registrant – Member                                                       q $ 204                         q $ 204                         q $ 226
• CCCO Workshop – Nonmember                                                                          q $ 332                         q $ 332                         q $ 332

Additional Tickets (Convention and MAP attendees and their guests)
• Welcome Reception Tickets                              # of Tickets __________                     q $ 90                          q $ 95                          q $ 100
• Passport to the World Reception Tickets                # of Tickets __________                     q $ 50                          q $ 55                          q $ 60
• President’s Banquet Tickets (by June 28)               # of Tickets __________                     q $ 135                         q $ 140                         q $ 145

                                                                                                                                            Page 2 Total $ ____________

Payment:           Payment required for processing. A confirmation e-mail will be sent to you.
Total Page 1: $__________
Total Page 2: $__________
TOTAL:           $__________                                   Signature _____________________________________                                           Date ______________

q Check payable in U.S. dollars to ACA International
q Credit card: q MasterCard                 q Visa q American Express

Card Number ______________________________________                                             Expiration Date _______________________________________

Print Cardholder’s Name ______________________________                                         Signature ___________________________________________
All credit card transactions are processed in U.S. dollars and are subject to the current exchange rates. International funds must be submitted in U.S. dollars.

Special Needs and Dietary Requirements
Additional fees may apply. ACA will do its best to accommodate your request as indicated below.
Please indicate if needs are for: q Registered attendee q Guest
   q Vegetarian         q Kosher: $75/meal          q Special Diet        q Vegan        q Allergy Considerations ________________________                           q Physical Needs

Please see information page for cancellation policies, registration deadlines and registration fee categories. By registering for this event, I hereby acknowledge
and agree that ACA International is not responsible for any injury, claim, liability or other cause of action of any kind based upon or resulting from my
participation in this event. By attending this event, I authorize ACA to use my image in any promotional or informational material produced by or on behalf
of ACA International. Any communication or material I do submit to ACA International will be treated as non-confidential and non-proprietary, and shall be
deemed the property of and may be used by ACA International, or its affiliates, for any purpose including developing, producing and marketing products for
commercial sale. ACA International may edit, copy, publish, distribute and otherwise use in any medium any submission to ACA International.                              Reg Code: L
                                                                                   ACA’s 71st Annual Convention & Expo • July 11-14, 2010
Registration Information                                                              Gaylord National on the Potomac • Washington, D.C.

Registration Fee Categories

ACA Convention Registration                                            First Registrant
Includes: All meal functions, the Opening General Session,             Identified as the first person who registers from an agency/
Welcome Reception, Monday and Tuesday breakfasts and                   affiliate/asset buying company. PDUs will be earned.
lunches, Passport to the World Reception and the President’s
Banquet, all convention education sessions, materials and              Additional Registrants
Collection Floor Management seminar, Expo 2010, plus legislative       Identified as additional registrants from the same member
activities on last day of convention.                                  company and location as the First Registrant. Individuals
                                                                       will receive PDUs. To receive additional person discounts,
MAP Conference Registration                                            all registrants must be registered for the same event, i.e.,
Includes: Two breakfasts, two Expo Hall lunches, a flash drive         Convention, MAP Conference, PPMS Seminar or CCCO Workshop.
containing the session materials, CLE accreditation applied for
upon request of those who register by May 7, 2010, the MAP             Spouse/Guest Meal Package (Convention Only)
special event, access to the Opening General Session at ACA’s          Individuals attending convention meal functions with a
Convention and access to the Welcome Reception in the Expo             registered attendee. This category does not include access to the
Hall at ACA’s Convention, plus legislative activities on last day of   educational sessions or PDUs.
                                                                       Daily Registration
Convention and MAP Conference Combination Registration                 Includes the full day of events and meal functions for the day you
Includes everything listed in both of the above descriptions.          are registered.
PPMS Registration                                                      Nonmembers
Includes: Friday & Saturday continental breakfasts, breaks and         Save on convention registration by joining ACA International.
lunches, and seminar materials.                                        To learn how to become a member, please contact the
                                                                       membership department at +1(952) 926-6547, or
Credit and Collection Compliance Officer (CCCO) Workshop     
Includes: Breaks, lunch and workshop materials.

Voting Privileges at                                                     Cancellation Policy
ACA’s Annual Meeting of the Membership                                   • Full refund minus a $75 processing fee per registrant will be
Agency/Affiliate/Asset Buyers:                                             processed for convention or MAP Conference cancellations
The first person from each company to register for convention is           received by ACA in writing no later than June 14, 2010.
eligible to vote.                                                        • A refund minus 30 percent of the registration fee will be
                                                                           processed per registrant for convention or MAP Conference
Members’ Attorney Program/Creditors International Members:                 cancellations received by ACA in writing between June
Each individual member attending convention/MAP Conference is              15–26. No refunds will be granted after June 27. However,
eligible to vote.                                                          you may send a substitute from your company. No refunds will
                                                                           be given for no-shows.

      Early-Bird Registration Discounts:                                              Need More Information?
  Register by May 14 and receive the best value for your money.                     Contact Campus ACA at +1(952) 926-6547.
 Registrations between May 15 and June 14 also receive savings                  Go to
        off our “late fees.” Don’t Delay—Register Today!                           or e-mail