United Trustees Association

EARLYBIRD REGISTRATION FORM- 38th Annual Educational Conference 2013 Please PRINT and FAX the registration form below. FAX: 949/260-9021 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 @ $695 per person (before September 30th) $ Second and Additional Member Attendee Registration Fee @ $595 per person (before September 30th) $ Non-Member Attendee Registration Fee @ $950 per person (before September 30th) $ Second and Additional Non-Member Attendee Registration Fee @ $950 per person (before September 30th) $ 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/Sole Attendee Fee (Monday Dinner) @ $125 per attendee (Note: Monday Dinner is included in the Conference Registration Fee) - Number of Guests: $ Attendees Attendees Certification Program 1   Certification Course @ $135 (registered attendee price, this includes lunch.) (Cost is not included in conference registration.) $ Please select one: Arizona I.... Nevada I.... Utah I.... Washington I.... California I.... California II Certification Course @ $185 (non-registrant fee, includes lunch) (Cost is not included in conference registration.) $ Please select one: Arizona I.... Nevada I.... Utah I.... Washington I.... California I.... California II 1– UTA Members may take the course and exam. Non-members may take the courses but only UTA Members may be certified. Members must pass California Level I in order to take California Level II.   Sunday Sonoma Valley Wine Tasting Tour @ $90 per attendee (Wine tour fees are not included in the conference registration.) $ Attendees   Attendees Attendees Attendees Sunday San Francisco NO Bike Tour @ $0 per attendee   Attendees   Attendees Attendees Attendees Sunday San Francisco WITH Bike Tour @ $30 per attendee (Bike tour fees are not included in the 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