AASC Conference Registration and Membership Dues Form
Name First: Last:
Organization Title: Organization:
Contact Info Email:

Business   Home
Street 1:
Street 2:
City: State:
Membership Are you a current AASC member?
No   Full   Associate   Student
Would you like to apply for membership?
No   Yes as an Associate   Yes as a Student  

Conference Registration Refer to membership and dues payment for status and price applied
Status: Unknown
Early Bird (through )$300$340
Regular ( through )$325$365
Late (After and Onsite)$425$465
Awards Luncheon Additional Ticket(s) (One included with registration) - $ each
Banquet Additional Ticket(s) (One included with registration) - $ each
Membership Dues None   Full   Associate   Student    
Allergies / Dietary Restrictions Please note any allergies, or dietary restrictions you or your guest(s) may have.
Events Attending icebreaker (Cost included with registration)
Yes   No
Interested in additional activity (Separate cost at event)
Yes   No
Discount Enter discount code (if you have one)
Discount will be applied at checkout
Processing Fee:
Total Cost:
You may pay online or mail a check. Online payment processes through PayPal. You don’t need to establish a PayPal account; you only need a debit or credit card.

Please note: We can only provide refunds less processing expenses through 14 June 2019.