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MCCA 11th Annual CLE Expo | March 20-22, 2012 Chicago Marriott Downtown | Chicago, IL
2012
NAME TITLE
ORGANIZATION ADDRESS CITY
PHONE E-MAIL
FAX
Please indicate your registration type:* $625 In House Counsel Early Bird Rate (Deadline: January 6, 2012) $725 General Registration Early Bird Rate (Deadline: January 6, 2012) $725 In-House Counsel (After January 6, 2012) $825 General Registration (After January 6, 2012)
3 WAYS TO REGISTER ONLINE
www.mcca.com (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
1/6/2012
$625 MCCA /ACC Member Rate $625 In-House Counsel Group Rate (Rate is per person; 3+ from the same law department)
Please indicate the session number you would like to attend for each time interval: Thursday, March 22, 2012
Wednesday, March 21, 2012
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
0:30
Yes, I will attend the Regional Networking Forum, Tuesday, March 20, 2012 5:00 PM - 9:00 PM Yes, I will attend the Member-Only programing, Wednesday, March 21, 2012 9:00 AM - NOON
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
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.
AMERICAN EXPRESS MASTERCARD EXP. DATE
Questions? Special Requests?
EMAIL
education@mcca.com
REGISTRATION FORM MCCA’s 11th PAYMENT METHOD
SESSIONS
Chicago Marriott Downtown | Chicago, IL
Annual CLE Expo | March 20-22, 2012 REGISTRATION ITEMS CONTACT INFORMATION
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