Conference Registration Form

If you’re interested in attending the 2011 MLBCF Conference, please fill out the form below or download, sign and mail in a copy of the forms.

1. Conference Registration Form (.pdf)
Online Registration
Please fill in all fields marked with a *
Personal Information
First Name
*
Last Name
*
Title
Company/ Organization:
Address:
 *
City:
 *
State:
 *
Zip:
 *
Contact Phone #:
 *
Alternate Phone #:
Email Address :
PO# :

 

GENERAL REGISTRATION
Registration fees cover the conference materials and handouts, admission to workshops and meal events. This does not include special events for the legislators. Conference activities begin on Friday, August 26th and end on Saturday, August 27, 2011. For additional information contact us by phone: 573-761-4166 or toll free 877-636-5223 or by email mlbcf@aol.com.

Regular Registration - $150.00

Conference Interests
I am interested in the golf tournament.

 

Individual Ticket Prices
Friday, August 26, 2011
Golf Team Registration @        $1200.00
Golf Course Individual Registration @        $300.00
Fish Fry/Reception @        50.00
Saturday, August 27, 2011
Workshops @        $35.00
Breakfast/Opening Session @        $35.00
Gwen Giles Luncheon @        $50.00

 

Table Information

Gwen Giles Luncheon
Saturday, August 27, 2011
Sponsorship Table(s)        @        $500.00
  (includes name on table and recognition in conference booklet)
Security Image:
       
***** If paying by credit card, please pay by clicking on the PayPal link on the home page. *****

**        You must register on-site after August 12, 2011
**        No Cancellations or refunds after August 19, 2011

            NO EXCEPTIONS TO THIS POLICY
                                                            
For additional conference information call - 877-63MLBCF or e-mail – mlbcf@aol.com

 
 
 
Missouri Legislative Black Caucus Foundation
4609 Paseo, Suite 102  |  Kansas City, MO 64110  |  Toll free 1-877-636-5223  |  Email: mlbcf@aol.com
The Foundation is tax exempt under section 501(C) (3) of the Internal Revenue Code. Contributions and deductible under Section 170 of said code.
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