CWCDAA 2012 Annual Summer Conference

The Cosmopolitan of Las Vegas, May 31 - June 3, 2012


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2012 CWCDAA Annual Summer Conference
The Cosmopolitan of Las Vegas
Las Vegas, NV
May 31-June 3, 2012

Registration Form

If you would just like to update your information but not register for the conference, please fill out the top half of this form and hit the submit button at the bottom for the page.

* indicates a required field

*Attendee Type:
* Attendee's Email Address:
Bar Number:
Salutation:
*First Name:
Middle Name:
*Last Name:
Title:
*Firm/Company Name:
*Address:
Address:
*City:
*State:
*Zip Code:
Alternate Email:
*Office Phone:
Fax:
Cell Phone:
Other Phone:
URL:

Please Create a Password:

If you are filling this out on behalf of someone else, please enter your email address below:
Email Address:

Office Location
Please let us know where your office is located:
      Northern California
      Southern California


Tickets
Please indicate the type of ticket that you would like to purchase and any guests that you would like have added to your purchase. If you have any questions or would like to purchase tickets for mulitiple people with the same credit card, please call our event manager, StageOne Events, Inc. at 925-240-9160.

Ticket Type:

Guests w/ meals, $175 each:
Guest passes will include all breakfasts and evening events.

Please indicate any need for services to accommodate a disability or dietary requirement:


Conference Materials
The CWCDAA will be making an attempt to control both cost and our environmental footprint this year by providing all of the conference materials digitally both prior to the conference via the internet for registered attendees and at the conference via digital media. While we feel that this transition is important and in the best interests of the Association and the environment, we also understand that some people still prefer to have the traditional conference binder. To this end, we will be offering the binder on-demand for $50. If you pick this option, we will have your binder printed and ready when you check-in. Please note, all binder orders must be in no later than May 1st. We will not have the ability to produce these binders on-site.

           Please order a conference binder for me (Add $50 to conference registration fee)

Golf Tournament
We are planning a Saturday morning Golf Tournament to benifit the Gerald M. Kennedy Scholarship Fun. If you would like to join us, please check below and we will email you the information and registration forms.

           I am interested in golfing. Please contact me with more information.

Gerald M. Kennedy Scholarship Fund
If you would like to make a donation to the Gerald M. Kennedy Scholarship Fund, please enter an amount below:
          None  $5  $10  $25  $50  $100  Other: 
Payment Method
Credit Card (Visa or MasterCard)
Check

Billing Information for Credit Card
Copy from registration above
First Name:
Last Name:
Address:
City:
State:
Zip:
Card Number:
Expiration Date:/

If you would rather mail or fax this form to us (paying by either check or credit card), please
print the registration form, fill it out, and mail it to us at:

Mailing Address:    CWCDAA
c/o StageOne Events
1304 Laysan Teal Dr.
Roseville, CA 95747

Please make checks out to: CWCDAA
Or you can fax the form with your credit card information to 925.396.6150.


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