| Required Fields are marked with a * |
Basic Information
* = Required Field |
| Last Name: |
A value is required.* |
| First Name: |
A value is required.* |
| AICP: |
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| Nametag Preference: |
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| Organization: |
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| Address: |
A value is required.* |
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| City: |
A value is required.* |
| State: |
Please select a valid item. Please select an item.* |
| Zip: |
A value is required.Invalid format.* |
| Phone: |
A value is required.Invalid format.* |
| Fax: |
Invalid format. |
| Email: |
A value is required.Invalid format.* |
Chapter Affilliation:
(Choose One) |
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| Dietary Restrictions: |
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Registration and Workshops (Choose One of Each) |
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| Registration: |
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| Reg. Total: |
$
Invalid format.Error: Total Cannot Be Zero here. Please pick a choice above.A value is required. |
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| Mobile Workshop: |
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$ |
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| Reception Tickets: |
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$ |
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| Grand Total |
$
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Session Choices (Choose One For Each Letter) |
| Thursday, September 4 10:15AM to 11:30AM |
| A: |
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| Thursday, September 4 2:00PM to 3:15PM |
| B: |
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| Thursday, September 4 3:30PM to 5:00PM |
| C: |
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| Friday, September 5 9:15AM to 10:30AM |
| D: |
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| Friday, September 5 10:45AM to 12:00PM |
| E: |
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| Friday, September 5 2:00PM to 3:15PM |
| F: |
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| Friday, September 5 3:30PM to 5:00PM |
| G: |
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| NOTE: By checking this box, I agree that the above information is correct, as it cannot be changed. Please double-check your information. |
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| PAYMENT OPTIONS |
| There are two payment options, either by check or through online payment using PayPal |
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I WILL PAY MY REGISTRATION WITH PAYPAL
PayPal is a way for people to buy products and services online without exposing their credit card information to the seller. PayPal handles all transactions and is independent of the RI-APA. It is safe, secure, and easy.
To learn more about PayPal, click here
I WILL PAY MY REGISTRATION BY CHECK
Please remit check payable to Rhode Island APA along with printed receipt to:
Fall 2008 Conference Rhode Island APA PO Box 14752 East Providence, RI 02914
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