Convention Registration (Step 1 of 3)

Venues
Conference and accomodations will be at the W Hotel Atlanta Buckhead.
Golf outing at Bear's Best Atlanta.

Deadlines
Convention Registration: September 21, 2009
Hotel Reservation: September 3, 2009

Register by Fax
If you prefer to register by fax, print the registration form (PDF format) and fax it to (847) 674-7366

Need help?
Email info@mflassociates.com or call (847) 673-2013.

* Indicates required field

About Me

First Name*:
Middle Initial:
Last Name*:
Name for Badge:	If different than name entered above
Firm Name:

Please use the billing address on file with your credit card company

Phone*:	(XXX) XXX-XXXX
Fax:	(XXX) XXX-XXXX
Email*:	A confirmation email will be sent to this address

Registration*:
With Guest/Spouse?:	Guest/spouse: $100
Guest/Spouse Name:
Golf - Bear's Best:	Golf: $250/person - for me Golf: $250/person - for my guest

I will attend the:

Thursday Business Meeting
Thursday Gala Reception
Friday Reception at Whiskey Blue

Credit Card:	Visa, MasterCard or American Express
Card Number*:
Name on Card*:
Expiration Date*:	/

To hotel reservations (optional)