Clone of Conference Registration Form with Payment

CMACOA 35th Annual Conference Registration
Friday, September 20, 2024 from 7:30am - 5:00pm at the Marriott Trumbull.

Attendance approved for 6 CE credits.

$130 per attendee if registered and paid by 11:59pm on August 15, 2024.

$150 per attendee after that time.

THERE WILL BE NO REGISTRATION/PAYMENT AT THE DOOR!
Agency*
City/Town/Organization
Phone*
Please enter the best phone number to contact your agency, or your own number if you are paying for yourself.
Number of attendees*
This form can accept up to 7 attendees. PLEASE BE SURE THIS # MATCHES THE QUANTITY IN THE PAYMENT CALCULATION BELOW!
Attendee 1

Professional TitleFirst NameLast Name
Attendee 2

Professional TitleFirst NameLast Name
Attendee 3

Professional TitleFirst NameLast Name
Attendee 4

Professional TitleFirst NameLast Name
Attendee 5

Professional TitleFirst NameLast Name
Attendee 6

Professional TitleFirst NameLast Name
Attendee 7

Professional TitleFirst NameLast Name
Email of Payer (where receipt will be sent)*

Confirmation Email
Form Calculation widget
PAYMENT CALCULATION*

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Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

CMACOA 35th Annual Conference Registration