Registration :(Print this page and fill out)
(VENDORS, Contact M.D. Smith at 256-536-8521, x103 or mdsmith@hiwaay.net) for info.)

Your Name (for nametag): _________________________________

Company: _____________________________________

Mailing Address: _________________________________________________________

City,State,Zip ____________________________________________

Phone (_____) _______________________

Fax (_____) _______________________

E-mail: __________________________________________

Check one: (includes LUNCH on Thursday, Feb. 16, 2006)
Member registration @ $75 _____________ & guests @ $75 ____________ = Total $___________________

Guest LUNCH only @ $35.00 each.

Non-Member registration @ $85 _____________ & guests @ $75 ____________ = Total $___________________

(You must sign up advance registration by February 5, 2006 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.