Saturday, November 3, 2012, Scottsbluff – Hampton Inn & Suites. First Name * Last Name * Email * Local Association Name Phone Number Are you registering for additional attendees? No – each member will individually register themselves. Yes – I will provide names below. Note that one member may register all members of their team on this form; or each person may individually register online, email, or by calling 800-742-0047. Additional Attendees Please enter first and last names of additional attendees from your local: For our meal planning purposes, please indicate your plans: Yes, I plan to have lunch at the conference. No, I do not plan on having lunch. Please let us know any dietary concerns or other issues we should be aware of:
