Please use your browser's PRINT command to print this registration form. Please complete one clearly printed or typed form for each registrant and mail to the address below.

Name:_______________________________________________________________________

Title:______________________________________________________________________

e-mail:_____________________________________________________________________

Address:____________________________________________________________________

City, State, ZIP:___________________________________________________________

Daytime Phone (with area code):________________________ FAX:_________________________

Please check:
__ City      __ State Agency      __ Academic Agency      __ Associate Member

__ County      __ Joint Power Authority      __ Special Agency      __ Affiliate Member

$225 Includes all conference sessions and discussions. Also the year 2000-01 $45 annual PASMA dues and the dinner banquet.

$375 Affiliate registration fee for vendors and non-public agencies.

Applying for Chapter Membership        Attendance at Conference Dinner
__ PASMA Northern California        __ Yourself
__ PASMA Southern California        __ Guest ($15) Guest's Name ____________________

Late registrations (postmarked after September 15, 2000) may be subject to a $50.00 late fee. Mail this application with your check payable to PASMA to:

PASMA
c/o Kerry Adamo
City of Sunnyvale
456 West Olive Avenue
Sunnyvale, CA 94088-3707

For more information, contact Marynka Rojas at (408) 277-3038 or e-mail at marynka.rojas@ci.sj.ca.us