Registration Form for 1999 Annual Meeting


        Degree/Title     First     Middle 
                  Last 
    Spouse/Guest       
             Address 
                   City    State    Zip    
                Phone 

Please choose the appropriate registration categories and curse down to send registration form:
ASD Member
$295

Non ASD Member - (**$100 may apply toward dues if you join ASD at the time of registration)
$395

Resident Member
No Charge

Non Member Resident
$100

Office Staff With Registered Member
$125

Office Staff Without Registered Member
$295

Guest With Registered Member
$125


**Join ASD with your registration and apply $100 of the $395 registration fee
toward dues and receive membership until August, 2000.
  Dues: $275 per year.



    Payment Options

My check for registration will be sent by mail.
Please bill me accordingly.






 

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