Name: Title: Name of Spouse or Guest: (Registration is Complimentary)
Name of Municipality/Company/Agency: Mailing Address for Billing:
Telephone: Fax: E-mail Address of Registrant:
Please check the day(s)you will be attending: Wednesday Thursday
Maine Chapter of American Public Works Association (MCAPWA)
Print for your Records
Do Not Pay From this Registration Form! You Will Be Invoiced
Questions/Cancellations: If you have questions or wish to cancel, call Louise Ridley at MMA, 1-800-452-8786. Notification must be given three business days in advance to obtain a refund. All cancellations are subject to a $10 administrative fee for processing. Registrations may be transferred to another official or employee. To ensure your complete participation in the convention, please inform us of any special dietary needs or special requirements you may have due to a disability.