United Trustees Association

REGISTRATION FORM- 35th Annual Educational Conference 2010 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 @ $595 per person (BEFORE September 30th) $ Second and Additional Member Attendee Registration Fee @ $495 per person (BEFORE September 30th) $ Non - Member Attendee Registration Fee @ $750 per person (BEFORE September 30th) $ Member Attendee Registration Fee @ $850 per person (AFTER September 30th) $ Non-Member Attendee Registration Fee @ $950 per person (AFTER September 30th) $ PAC Contribution Voluntary contributions to the Political Action Committee (CTA-PAC) will be used to promote sound legislation, oppose adverse legislative proposals and support California political leaders who foster the growth of our industry. 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.... 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.... 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 Golf Registration UTA Member @ $180 per attendee (Golf fees are not included in the conference registration.) $ Non-Member or Late Participant @ $200 per attendee (after September 30th) $ Attendees   Handicap Attendees Handicap Attendees Handicap Attendees Handicap   For sponsorship information, click here     Sunday Bowling Tournament Registration UTA Members @ $75 per attendee (Bowling fees are not included in the conference registration.) $ Non- Member or Late Participant @ $85 per attendee $ Attendees   Attendees Attendees Attendees   For sponsorship information, click here 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