NCSL Registration Form

Please complete this registration form and mail or fax it to NCSL.

Name___________________________________________________________________

Title____________________________________________________________________

Affiliation________________________________________________________________

Address_________________________________________________________________

City_________________________________State________________Zip_____________

Phone___________________________________________________________________

Registration Fees
$395	State legislator, legislative staff
$425	Government, university, union and small nonprofit organizations (budgets less than $1 million)
$505	Foundation for State Legislatures and large nonprofit organizations (budgets more than $1 million)
$570	All others
$145	Guests
Paying by:		Check Enclosed	Visa	MasterCard
Bill the state		American Express	Diners Club	Pay on site
Voucher/Purchase Order No.

Credit card no. ____________________________________Exp. Date__________

Signature______________________________________________________________

Registration fees are payable in advance or onsite.

To pre-register, complete this form then mail or fax by April 9, 2003 to:

NCSL Registration
P.O. Box 17972
Denver, Colorado 80217
(303) 364-7700 - fax (303) 364-7811