LSI's 2nd Quarterly Conference

"FALL INTO WINTER"
November 9-11, 2018
Silver Legacy Resort
407 N. Virginia Street, Reno, Nevada 89501
www.silverlegacyreno.com

Please use the form below to register.

If you choose to pay by Pay Pal or credit card a $3.00 surcharge is added to the price of registration and you will be taken to Pay Pal to complete payment. Note, you can use your credit card with Pay Pal if you do not have or do not want to use a Pay Pal account.

A $10 fee will be added to registrations made after October 9, 2018

Please fill out a separate form for each attendee.

Download the Registration Form

Name of Attendee (as it will appear on badge):*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Cell/Home Phone

Work Phone

Local Association

LSA / LPA

LSA
LPA

Please check if you are:

President
Govenor
CCLS
PLS

Please check if applicable (include title):

State Officer
State Chairman

Title:

Payment Method*

By Pay Pal or Credit Card
By Check

Scrip Tickets

Scrip Ticket (includes Registration, Welcome Reception, Banquet and Brunch)

Scrip Ticket

Scrip Ticket (includes Registration, Welcome Reception, Banquet and Brunch)

Scrip Ticket

Individual Tickets

Registration
Welcome Reception (Friday)
President's Luncheon (Saturday)
Governor's Luncheon (Saturday)
Open Luncheon (Saturday)
Banquet (Saturday Night)
Brunch (Sunday)

Individual Tickets

Registration
Welcome Reception (Friday)
President's Luncheon (Saturday)
Governor's Luncheon (Saturday)
Open Luncheon (Saturday)
Banquet (Saturday Night)
Brunch (Sunday)

Total

$0.00

MEAL CHOICES Please select a meal option for each ticket you order. If you ordered a scrip ticket please remember to make a choice for the Banquet.

President's Luncheon

Chicken Ciabatta Sandwich
Chicken Cobb Salad

Governor's Luncheon

Chicken Ciabatta Sandwich
Chicken Cobb Salad

Open Luncheon

Chicken Ciabatta Sandwich
Chicken Cobb Salad

Banquet

Prime Rib
Pork
Chicken

Special Dietary Request:

Vegetarian

General Comments

NOTE: Cancellations must be received 24 hours in advance for a refund. No-Shows will be billed.

NOTE: Cancellations must be received 24 hours in advance for a refund. No-Shows will be billed.

Once you submit this form, you will be sent an e-mail that you can print and send it with your check.

Please make you check payable to: SCCoLPA NOV 2018 CONF.

Return the form and payment to:

M'Liss Jarvis Bounds
c/o Hoge, Fenton, Jones & Appel, Inc.
60 South Market Street, #1400
San Jose, CA 95113
Phone: (408) 938-3808
Email: sccolpaconference@gmail.com

LSI’s 2nd Quarterly Conference