Registration Form for 1999 Annual Meeting

        Degree/Title     First     Middle 
                   City    State    Zip    

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

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

Resident Member
No Charge

Non Member Resident

Office Staff With Registered Member

Office Staff Without Registered Member

Guest With Registered Member

**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.