United Trustees Association

EARLYBIRD REGISTRATION FORM- 41st Annual Educational Conference 2016 Please PRINT and FAX to 949-260-9021 or SCAN and EMAIL to rmeyers@unitedtrustees.com Primary Attendee Additional Attendees Additional Attendees Company Name Address City State/Provence Postal/Zip Code Email Phone Fax PRICING INFORMATION Full Conference Registration (Conference Registration Fee includes Monday Dinner Event )   First Member Attendee Registration Fee @ $995 per person $ Second and Additional Member Attendee Registration Fee @ $895 per person $ Non-Member Attendee Registration Fee @ $1695 per person $ Second and Additional Non-Member Attendee Registration Fee @ $1695 per person $ Legal-Amicus Fund Contribution Legal Defense-Amicus Fund contribution will be used to support UTA's amicus brief program. We respectfully request a minimum contribution of $50.00 $ Please select one: Individual Corporate Monday Dinner Event Registration ONLY Spouse/Guest Fee (Monday Dinner) @ $125 per attendee (Note: Monday Dinner is included in the Conference Registration Fee) Number of Guests: $ Attendees Attendees Sunday 23rd Annual Golf Tournament @ $225 per attendee (Green fees are not included in conference registration.) $ Attendees   Attendees Attendees Attendees Sunday Cooking Class @ $100 per attendee (Cooking Class fees are not included in conference registration.)   Attendees   Attendees Attendees Attendees Sunday Hummer Tour @ $119 per attendee (Hummer Tour fees are not included in conference registration.)   Attendees   Attendees Attendees Attendees Credit Card Information Check One:      MasterCard      Visa        Check Total Amount $: Card Number: 3 Digit Security Code at the back of the card (CCV): Expiration Date: Name on Card: Billing Address: City, State, Zip: Signature: _____________________________ Please mail to: United Trustees Association 2030 Main Street, Suite 1300 Irvine, CA  92614