Region 5 - 3nd Annual Tennessee Statewide Payroll Conference
hosted by: Chattanogga, TN Chapter of the APA
assisted by the Greater Nashville Chapter of the APA

August 4 - 6, 2010

****please note: if you are NOT a member of the Chattanooga Chapter - you must pay the Non-Member cost.
Early Bird Registration
Chattanooga Members: TBA
Non-Chatt attendees: TBA		 Regular Registration
Chattanooga Members: TBA
Non-Chatt attendees: TBA
 Late Registration
Chattanooga Members: TBA
Non-Chatt attendees: TBA

Conference registration fee includes meeting materials, continental breakfast and lunch on Thursday / Friday, and Dinner (Thursday night only). The Statewide Conference reserves the right to limit enrollment to insure that stated objectives are achieved. You will receive a confirmation of your registration upon submission of this registration form and applicable registration fees.

Attendee Registration Form
Complete the entire form or the form will not submit
Your Full Name:
Your Title:
Your Company Name:
Your Mailing Address:
City / State / Zip:
Contact Phone Number:
Fax Number:
E-Mail address:
Certification(s) please list all:
APA Chapter Name:
SPOUSE / GUEST NAME:
*I will be there on Wed. night and attend the welcome reception:  YES:
Workshops / Sessions:  Make one selection per session
Workshop Session 1:
Please select ONE of the three options:
Workshop Session 2:
Please select ONE of the three options:		 a:                  
b:
c:
Workshop Session 3:
Please select One of the three options:
Workshop Session 4:
Workshop Session 5:
Workshop Session 6:
Please select ONE of the three options:
Workshop Session 7:
Please select ONE of the three options:		 a:
b:
c:
A List of Conference Attendees will be published.
  
Registration Fee: "A"
Lunch (8/5/2010): ($25.00 per additional person): "B"
Lunch (8/6/2010): ($25.00 per additional person): "C"
Dinner: ($75.00 per additional person): "D"
Total for A, B, C, and D:

Do you have any Special Dietary Needs?
Payment Method:

I will send a Check or Money Order

I will bring a Check to the Conference

Make Checks Payable to:

Cancellation Policy:
The TN Statewide Payroll Conference will not honor cancellations.  Participant substitutions may be requested by contacting: