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�s�ar <br />�t�a■ <br />League of California Cities City/Agency <br />Community Services Conference <br />Thursday - Friday, April 10 -11,1997 <br />The Westin Hotel at Horton Plaza, San Diego <br />ADVANCE CONFERENCE REGISTRATION FORM <br />Enter first and last names and official title as they should appear on conference badge and registration card. Please indicate spouse's <br />name (if spouse is not a city or public official) if attending. <br />NAME TITLE SPOUSE INDICATE DAY IF <br />1 DAY REGISTRATION <br />To help us pian for any special needs, please call the Conference registration office at 510/283-2113 if any registrant requires special <br />accommodations for disabilities. <br />ADVANCE REGISTRATION DEADLINE for BONUS is Wednesday, March 26,1997. After this date please' register on site <br />Full Conference One Day Only <br />City Officials @ $240 City Officials @ $150 <br />Non -City Public Officials @ $265 Non -City Public Officials @ $175 <br />TOAll TAL $290 All Others Q <br />S 5200 <br />TOTAL S <br />PAYMENT INFORMATION: Check which is enclosed (no purchase orders, American Express or Discover cards). Make <br />checks payable to League of California Cities. <br />City Check Personal Check VISA Mastercard <br />Name on Credit Card: <br />Authorized Signature: <br />Credit Card Number: Expiration Date: <br />REGISTRATION RECEIPTS will be mailed to the person below, who agrees to give receipts to each registrant: <br />Name: <br />Title: <br />Address: <br />City: Zip: <br />Telephone: ( ) Fax: ( ) <br />This form must be postmarked by Wednesday, March 26,1997. Please mail to: <br />League of California Cities <br />P.O. Box 1519 <br />Lafayette, CA 94549 <br />510/283-2113; (for those paying with credit card ONLY you may FAX 510/283-7833) <br />He <br />