annual
3 WAYS TO REGISTER ONLINE 2013
NAME TITLE
ORGANIZATION ADDRESS CITY
PHONE E-MAIL
FAX
Please indicate your registration type:* $625 In-House Counsel Early Bird Rate (Deadline: January 11, 2013)
www.mcca.com/cleexpo2013 (credit card only)
FAX form to (202) 739-5999
MAIL form and check to: Minority Corporate Counsel Association 1111 Pennsylvania Avenue NW Washington, DC 20004
STATE
ZIP CODE
1/11/2013
$725 General Registration Early Bird Rate (Deadline: January 11, 2013) $725 In-House Counsel (After January 11, 2013) $825 General Registration (After January 11, 2013)
Questions? Special Requests? EMAIL
$625 Members of MCCA, CMCP & ACC/FANs/CLE Expo Sponsors Rate** $625 In-House Counsel Group Rate (Rate is per person; 3+ from the same law department)
(General registration applies to law fi rm attorneys and employees of legal service providers.)
Please indicate the session number you would like to attend for each time interval: Wednesday, March 6, 2013
Thursday, March 7, 2013
2: 00 PM - 3:30 PM 4: 00 PM - 5:30 PM
9: 00 AM - 10:30 AM 11:00 AM -12:30 PM 2: 30 PM - 4:00 PM
101
102 103
10:30 AM - 12:00 PM 2:00 PM - 3:30 PM 4:00 PM - 5:30 PM
Yes, I will attend the Thomas L. Sager award Reception, Tuesday, March 5, 2013 5:30 PM - 7:30 PM (Complimentary with CLE Expo registration)
Note: Registration is NOT CONFIRMED until payment has been received. CHECK (Enclosed)
VISA CREDIT CARD NUMBER
PRINT CARDHOLDER’S NAME CARDHOLDER’S SIGNATURE BILLING ADDRESS
AMERICAN EXPRESS MASTERCARD EXP. DATE
education@mcca.com
Check here if billing address is the same as listed in contact information
*By submitting this form, you agree to MCCA’s cancellation policy. MCCA is a not-for-profi t organization classifi ed under section 501(c)(3) of the Internal Revenue Service Code. MCCA’s tax identifi cation number is 13-3920905.
** MCCA corporate members receive up to 3 complimentary registrations to attend the CLE Expo. Contact a staff member at
education@mcca.com for details.
REGISTRATION FORM MCCA’s 12th SESSIONS
PAYMENT METHOD
Hard Rock Hotel | San Diego, CA
Annual CLE Expo | March 5-7, 2013 REGISTRATION ITEMS CONTACT INFORMATION
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