Registration Form - MAPP Home Page by leader6

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									                                                   May 12 – May 14, 2010
                                              MAPP Conference Registration Form

                   A New Decade of Public Purchasing: Being Challenged. Being Capable. (BCBC)
                                   “Make your ripple at the Lake of the Ozarks.”

Registration Information:

Name:_______________________________________________________Title:______________________________

Entity:__________________________________________________________________________________________

Address:________________________________________________________________________________________

Phone:________________ Fax:_______________ Email: ________________________________________________

First Time Attendee (Y or N): ___________                      Mentor Requested (Y or N):____________

Special assistance requested or special dietary needs (Please Specify)____________________________________

Emergency Contact Information:
_______________________________________________________________________________________________

Registration Fees: Fees for Full or Daily Registration & Guest Meals are listed below. Note: All sessions, meals
and entertainment are included in the Full Registration. Daily Registration includes the sessions, meals and
activities for the respective day.

Full Registration:
______MAPP Member ($155)                    _____Non-Member ($185)                   _____Lifetime/Honorary Member
*Scholarships are available                 *MAPP Membership Dues~ $30
                                            If a „Non-Member‟ and would like $30 of fees to apply towards a one year
                                            MAPP membership, please (x) here: _______
Daily Registration:
Wednesday Only: _______MAPP Member ($45) _______Non-Member ($55)
Thursday Only:      _______MAPP Member ($70) _______Non-Member ($80)
Friday Only:        _______MAPP Member ($40) _______Non-Member ($50)

Guest meals:                 Guest name :
____Thursday hot Breakfast buffet ($21.00)
____ Thursday Luncheon ($19.00)
____ Friday Hot Breakfast Buffet ($21.00)

REGISTRATION DEADLINE: Conference registration must be received by 12:00 pm on April 15, 2010. Please return
this registration form, with a purchase order or check made payable to MAPP, to the following address: The Missouri
Department of Transportation – District 5 Central Office, Attn: Corey Duemmel, 1511 Missouri Blvd., PO Box 718,
Jefferson City MO 65102;               office phone:     (573) 526-6956; fax:        (573) 526-6796; and Email:
corey.duemmel@modot.mo.gov
Note: SAM II Vendor #4317931670-2

HOTEL INFORMATION: The conference will be held at The Lake Ozark Country Club Hotel & Spa, located in Lake
Ozark, MO. The room rate for this conference is $96.00 per room per night plus resort fee. Must show tax exemption
certificate. Reservations must be made at the hotel no later than April 15, 2010. You must indicate you are attending
the MAPP conference to receive the confirmed rate. Contact information regarding the hotel is:
                Lake Ozark Country Club Hotel & Spa
                250 Racquet Club Drive, P.O. Box 1599 • Lake Ozark, Missouri 65049
                http://www.countryclubhotel.com/index.php
                Toll Free: (800) 964-6698
                Phone: (573) 964-2200 ■

								
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