Registration Form
ESCOP Executive Committee Meeting
April 25-26, 2000
Memphis, TN

Registration Deadline: April 1

Please print this form, fill in the appropriate information and mail with registration fee.

Name:
(as desired for badge)		 ___________________________________________________
Title: ___________________________________________________
Address: ___________________________________________________
City, State, Zip: ___________________________________________________
Organization: ___________________________________________________
Email address: ___________________________________________________
Phone and Fax#: ___________________________________________________

Registration Fee: $140
(Includes 2 breakfasts, 2 lunches,
3 breaks, meeting room,
and audio-visual equipment costs.)

Make check payable to:
Mississippi State University
[Federal Tax ID# 64-6000819]

Mail form and payment to:

ESCOP Exec. Committee Meeting
Sou. Assoc. of AES Directors
Box 9656
Mississippi State, MS 39762

If you have questions, please e-mail Anna Marie Rasberry, call 662-325-1773, or fax 662-325-8915.

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