REG FORM.pub

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14TH ANNUAL INFRASTRUCTURE FINANCE CONFERENCE Isleta Resort, Albuquerque - October 27 - 29, 2009 ADVANCE REGISTRATION FORM Please fill out form completely ( print or type) Name / Title *Spouse/Guest Registration: (Must be paid in advance or on site—no billing for Spouse/Guest) *Spouse/Guest Name, if attending Municipality, Organization, or other Affiliation Full Conference includes all meals and social functions Full Conference by October 19th Full Conference after October 19th @ $105/ person @$120/person $ $ Mailing Address - Include City/State/Zip Billing Address - Include City/State/Zip Price Per Function: Tuesday Reception Wednesday Luncheon @ $25/ person @ $30/ person @ $25/ person @ $25/ person TOTAL DUE I Prefer Vegetarian Meals ADA/Special Needs: Contact Anita Tafoya or Jackie Portillo @ 800-432-2036. $ $ $ $ $ Phone Fax Email Address Wednesday Social Thursday Awards Breakfast $175 $190 $220 Please Appropriate Box: Full Conference Registration: (Includes all meals) Registration by October 13th Late Registration after October 14th – 19th On Site Registration after October 19th (On Site Registrants must have PO# or pay on site) I Prefer Vegetarian Meals ADA/Special Needs: Contact Anita Tafoya or Jackie Portillo @ 800-432-2036. Guest/Spouse Registration Fee Payment Information: Check for registration fees made payable to NMML. (Please include Guest/Spouse name on check/stub) Enclosed or provide PO#: Charge my registration fees to VISA or MasterCard listed below. The New Mexico Municipal League is authorized to use the card below to pay all applicable registration fees in the amount of: $ VISA/MasterCard # (Circle one) Card Holder Name (Printed) Card Holder Signature Exp. Date Registration Fee Payment Information: Check for registration fees made payable to NMML. (Please include registrant’s name on check/stub.) Enclosed or provide PO#: Charge my registration fees to VISA or MasterCard listed below. The New Mexico Municipal League is authorized to use the card below to pay all applicable registration fees in the amount of: $ VISA/MasterCard # (Circle one) Card Holder Name (Printed) Card Holder Signature Exp. Date Will bring to Meeting Purchase Order for Registration Fees attached Will bring to Meeting Purchase Order for Registration Fees attached PLEASE COMPLETE THIS FORM AND MAIL/FAX BY OCTOBER 19TH TO: Cherise Quezada - New Mexico Municipal League P.O. Box 846 - Santa Fe, NM 87504-0846 Fax # 505-984-1392 OR REGISTER ONLINE AT www.nmml.org After October 19th you must register on site. All requests for cancellation must be received in writing by October 19, 2009. Cancellations received after October 13th will be charged a $50.00 cancellation fee. No refunds will be given after October 19th. No registrations or cancellations will be accepted by telephone. No partial refunds will be made if you decide not to attend particular functions. If you have preregistered and do not attend without cancelling your registration, you are responsible for full conference registration fee. This policy also applies to Guest/Spouse registrants. - REGISTRATION CANCELLATION POLICY -

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