Serving Copiah, Hinds, Madison, Rankin, Simpson, Warren, and Yazoo Counties...
Fill out our ONLINE REGISTRATION FORM...
First Name/Last Name/MI:
/ /
Badge Name:
Title:
Organization:
Street (or) Box Address:
City/State/Zip:
/ /
Phone #:
E-Mail:
Please Check Approicate Fee Option(s):
Registration (Before 4/17/05) $260
Late Registration (After 4/17/05 $310)
*Spouse Registration ($50)
*Registered Spouses Name:
Continuing Education Units will be offered as Social Work Units.
Please check the box to sign-up for SWU's.
MML will offer Continuing Education Credit to municipal officials.
Please check the the box if you plan to participate.
The MAPDD/Valley Golf Tournament is a special event offered to all conference registrants compliments of Valley. You must register before April 14, 2006. Please check the box below to sign-up.
Golf Tournament - Tuesday, April 25 (Average Score: )
Please check the box to sign up for the Riverboat Cruise.
Please check a box to reserve a seat on the bus for the Wednesday night trip of your choice. Bus to ClarksdaleBus to Memphis
For printout, print before submitting registration.
Full Conference Registration Fee includes registration and admission
to all Conference Activities. Conference Dress will be casual.
