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AGACL CONFERENCE PRE-REGISTRATION FORM FOR ONLINE REGISTRATION
33rd Annual Conference
San Francisco, California, July 25-28, 2012

Note: Please use the tab key to navigate through this form. Hitting the Enter key will cause the form to be submitted. All fields marked with an asterisk must be completed.


Name (First and Last) *
Title *
Agency *
Address 1 *
Address 2
City *
State *
Zip Code *
E-mail Address *
Phone Number *
Fax *
My office is a member of AGACL Yes *
No
(If the office membership is held in the name of someone other than the registrant, please indicate the member's name here)
Membership type Board member *
Member - $450
Non-member - $550
My guest will attend the cocktail party reception (Wednesday). $35 is enclosed.
(Reception is included in the registration fee for attendees.)
Additional comments
 
Please send the registration fee to the address below (check or money order; credit cards not accepted). Government ID will be required at check-in.
Cancellation policy: A cancellation fee of $150 will be charged if notice of cancellation is not received by 5:00 pm on July 23, 2012.

Please make checks payable to:

ASSOCIATION OF GOVERNMENT ATTORNEYS
IN CAPITAL LITIGATION
Send to:

AGACL
PMB-102
125 North 2nd Street, Suite 110
Phoenix, Arizona 85004-2370
(602) 938-5793; FAX (602) 938-5793
E-mail: agacl@msn.com

NOTE: If you do not receive a confirmation from AGACL, please call to confirm receipt of the registration.

Federal ID No. 61-1011364

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Email: agacl@msn.com