Name: Title:   

APCO Membership No.   TCLEOSE PID No.

                Company/Agency:

  Address: State: City: Zip:

                 Phone: Fax: Email:

  REGISTRATION INFORMATION

Full registration includes: Exhibits, seminars, Luncheon

Day Passes include: Participation for that days events.

Early registration is before March 29, 2008

  CHOOSE APPROPRIATE CATAGORY APCO Member Early Registered $80 APCO Member Late Register $90 Non-Member early register $90 Non-Member Late Register $105 One Day Pass $45 Member Spouse $35 Non-Member Spouse $45

Hotel registration must be made separately.

METHOD OF PAYMENT

Please check one:

CHOOSE APPROPRIATE PAYMENT METHOD Payment in mail, following this online registration (Check or Credit Card) Will make payment upon arrival to conference. Pay by Credit card (AMEX,Visa,Mastercharge) Mail this form with payment info Purchase Order Number. Number entered below.

Purchase Order Number:

CONTACT INFORMATION

For more information and to mail payments:

Kim Killion, Registration Chair

North Richland Hills, P.D

7301 N.E. Loop 820

North Richland Hills, TX 76182

(817) 427-7194  Fax (817) 427-7121