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2010 ANNUAL MEMBER MEETING
November 3,4 and 5, 2010
The Atherton Hotel
125 South Atherton Street
State College, PA 16801
Tel: 800-832-0132 or 814-231-2100
Fax: 814-237-1130

Registration Form

Registration Fee:          Member*        $250.00                  Non-Member                $300.00

                    Spouse/Guest         $150.00                        Spouse/Guest                $150.00

Registration Fee:          State Officials                $125.00

*Additional members will pay $250.00 each and $150.00 for a spouse/guest

COMPANY NAME OF MEMBER(S):_____________________________________________

Enclosed is payment in the amount of $___________, representing for the following individuals:

Attendee:_____________________________________________________________________

Spouse/Guest:_________________________________________________________________

Attendee:_____________________________________________________________________

Spouse/Guest:_________________________________________________________________

Attendee:_____________________________________________________________________

Spouse/Guest:_________________________________________________________________

Attendee:_____________________________________________________________________

Spouse/Guest:_________________________________________________________________

TOTAL NUMBER OF PEOPLE ATTENDING (Attendees & Spouse/Guest)_______________

Return REGISTRATION FORM & REGISTRATION FEE on or before October 3, 2010:

PAAMA
c/o Steve Fulk
730 Cardinal Drive
Harrisburg, PA 17111