AzACRAO Summer Workshop Meeting Registration Form

AzACRAO Fall Conference

September 25, 2008

Registration Form

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First Name:

Preferred Name:

(required - for name tag)

Last Name:

Title:

Institution/
Affiliation:

Mailing Address:

Address (cont.):

City:

State: Zip:

Phone:

FAX:

Email:

Alternate
First Name:

Preferred Name:

(required if alternate attending - for name tag)

Alternate
Last Name:

Comments or
Special
Accommodations
Required:

Registration fee is $50 up toSeptember 1st and $75 after September 1st.
Please make checks payable to AzACRAO.

Payment may be made at check-in or mailed to:

Fernando Munguia
Supervisor of Admissions and Registration
Pima Community College - Downtown Campus
1255 North Stone Avenue
Tucson, Arizona 85709-3040
Phone: 520.206.7106
Fax: 520.206.7288

Last updated: Saturday April 12, 2008