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2019 Annual MACA Summer Conference Registration
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2019 Annual MACA Summer Conference Registration
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Registration Category
*
- Select -
Tax Assessor/Collector and one guest (NO FEE)
Deupty Assessor/Collector and one guest ($300)
Deputy Tax Assessor/Collector ($150)
Retired ($150)
Contract Appraiser ($500)
First Name
*
Last Name
*
What is your Title?
*
- Select -
Tax Assessor/Collector
Tax Assessor
Tax Collector
Deputy
Contract Appraiser
Retired
County/Organization
*
- Select -
Adams County
Alcorn County
Amite County
Attala County
Benton County
Bolivar County
Calhoun County
Carroll County
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Forrest County
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George County
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Simpson County
Smith County
Stone County
Sunflower County
Tallahatchie County
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Tishomingo County
Tunica County
Union County
Walthall County
Warren County
Washington County
Wayne County
Webster County
Wilkinson County
Winston County
Yalobusha County
Yazoo County
Contract Appraiser
Mississippi Department of Revenue
Retired
Address
*
City
*
State
*
Alabama
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American Samoa
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Connecticut
Delaware
District of Columbia
Florida
Georgia
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Zip Code
*
Phone Number
*
Email Address
*
Do you need to register any children under the age of the age of 14? (Children age 14 or older must be registered as a regular guest).
*
Yes
No
Price list for Youth Ages 0-6 (no fee) Ages 7-13( $75) Ages 14 & Up ($150) Must register as regular guest
How many children are you registering ages 7-13?
*
0
1
2
3
4
5
First Name & Last Name
Age of Child
First Name & Last Name
Age of Child
First Name & Last Name
Age of Child
First Name & Last Name
Age of Child
First Name & Last Name
Age of Child
If there is a group bowling event held during conference, would you attend? (Detials to be released at a later time.)
*
Yes
No
Please select the events that you will attend (Please ONLY select the events you WILL attend)
*
Monday Pre-Conference Session
Tuesday Breakfast
Tuesday Lunch
Wednesday Breakfast
Wednesday Lunch
Wednesday GALA & President's Reception
Thursday Prayer Breakfast
Will you be bringing a guest?
*
Yes
No
Guest's First Name
*
Guest's Last Name
*
GUEST INFORMATION Please select events that events that your guest will attend (Please ONLY mark events that your guest WILL attend)
*
Monday Pre-Conference Session
Tuesday Breakfast
Tuesday Lunch
Wednesday Breakfast
Wednesday Lunch
Wednesday GALA & President's Reception
Thursday Prayer Breakfast
Will you be bringing an ADDITIONAL guest?
*
Yes ($150)
No
First Name of ADDITIONAL Guest
*
Last Name of ADDITIONAL Guest
*
ADDITIONAL GUEST INFORMATION Please select events that events that your guest will attend (Please ONLY mark events that your guest WILL attend)
*
Monday Pre-Conference Session
Tuesday Breakfast
Tuesday Lunch
Wednesday Breakfast
Wednesday Lunch
Wednesday GALA & President's Reception
Thursday Prayer Breakfast
Will you be bringing a 2nd ADDITIONAL guest? (If you plan to bring more than TWO (2) ADDITIONAL GUEST, please contact Terence Norwood @ 662-325-3141)
*
Yes ($150)
No
First Name of 2nd ADDITIONAL Guest
*
Last Name of 2nd ADDITIONAL Guest
*
2nd ADDITIONAL GUEST INFORMATION Please select events that events that your guest will attend (Please ONLY mark events that your guest WILL attend)
*
Monday Pre-Conference Session
Tuesday Breakfast
Tuesday Lunch
Wednesday Breakfast
Wednesday Lunch
Wednesday GALA & President's Reception
Thursday Prayer Breakfast
Persons with disabilities, food allergies etc. that require special accommodations, please use the space below to notify conference coordinators.
Payment Type
*
Mail Check
eCheck
Total
{registration_category} + ({how_many_children_are_you_registering_ages_7_13} *75)+{will_you_be_bringing_an_additional_guest} + {will_you_be_bringing_a_2nd_additional_guest}
Make Checks Payable to:
Extension Center for Government and Community Development
Attn: MACA Annual Convention
Box 9643
Mississippi State, MS 39762
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