Signup For ALSSA EXPO 2007

EXPO January 17-18, 2007 at Wynfrey Hotel, Rivergate Galleria, Birmingham

Participant Registration :(Print this page and fill out)

PRINT Your Name (for nametag): ___________________________________________

Company: __________________________________________________

Mailing Address: _________________________________________________________

City,State, _________________________________________________________ Zip ____________

Phone (_____) _______________________ - - - Fax (_____) _______________________

E-mail:(Important) __________________________________________

Check one or more: (includes LUNCH on Thursday, Jan. 18, 2007)

Expo Member registration @ $85 _____________ & guests @ $85 = ____________ Total $___________________

Guest LUNCH only @ $35.00 each. = ______________ Total $___________________

Non-Member registration @ $95 _____________ & guests @ $95 = ____________ Total $___________________

(You must sign up advance registration by January 5, 2007 or pay added $10 late fee. You can also purchase tickets at the door. )(Vendors & Exhibitors please contact M.D. Smith - see main expo page)

Enclosed is my CHECK (pay to order of ALSSA ) for $ ___________________

Mail form and Payment to:

Make your room reservations at the Wynfrey Hotel early. See main page for information.