49th ANNUAL CONFERENCE Little Rock Marriott/
Statehouse Convention Center August 9-11, 2017
PRE-REGISTRATION Received Before 8/4/17
$125.00 $ 80.00 $145.00
officials, employees, guests spouses
non-members
ON-SITE REGISTRATION Received After 8/4/17
$145.00 $100.00 $165.00
LITTLE ROCK MARRIOTT/STATEHOUSE CONVENTION CENTER
PLEASE USE THIS FORM ONLY IF YOU PLAN TO PAY BY CHECK. WE OFFER ONLINE REGISTRATION FOR THOSE PAYING BY CREDIT CARD. GO TO
WWW.ARCOUNTIES.ORG.
PLEASE FILL OUT A SEPARATE FORM FOR EACH COUNTY EMPLOYEE. YOU MAY COPY THIS FORM – INCOMPLETE FORMS WILL NOT BE PROCESSED.
NAME COUNTY ADDRESS
EMAIL ADDRESS: SPOUSE/GUEST REGISTERING: ($80.00 Spouse - $125.00 Guest) YES
SPOUSE/GUEST NAME (non county employee) AMOUNT ENCLOSED:
NO (Make Check Payable to: Association of Arkansas Counties) CONFERENCE REGISTRATION FEES MUST ACCOMPANY THIS FORM BEFORE REGISTRATION CAN BE PROCESSED.
RETURN THIS COMPLETED FORM TO AAC, 1415 WEST THIRD STREET, LITTLE ROCK, ARKANSAS, 72201, ALONG WITH A PAYMENT MADE PAYABLE TO THE ASSOCIATION OF ARKANSAS COUNTIES NO LATER THAN AUGUST 4, 2017.
Refund Policy: If you notify the AAC Office before 4:30 p.m. on Friday, August 4, you will receive a refund on your con- ference registration fees. If notification is not made by this time, a refund will not be processed under any circumstances.
TITLE CITY/ZIP
officials, employees, guests spouses
non-members
MAIL TO: Association of Arkansas Counties Annual Conference 1415 West Tird Street Little Rock, Arkansas 72201
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