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Home > 2009 ACCC Symposium and Leadership Roundtable

ACCC Symposium and Leadership Roundtable
September 2-3, 2009
Wichita, Kansas
Wichita Marriott

Registration fees: $195 per person                             

Registration deadline:  Wednesday, August 19, 2009                                               

         David Barton (by e-mail or phone, 785-532-1508) 
                                               
         Seleise Barrett  (by e-mail or phone, 785-532-1522)

**NOTE: you may use the "tab" button to move through the form but do NOT use the "enter" as that will submit the form and you'll have to start over.

Please fill out this form as many times as needed to register all of the people for your co-op or business. The confirmation page has a link to return to this form.

Name (first and last):

Badge Name (if different from above):

Title:  

Company: 

Mailing Address:    

City:        State:       Zip: 

Telephone:          Fax:    

E-mail: 

I plan to attend the following meals which are included in my registration fee:

     Yes    No   Lunch, Wednesday, September 2nd

     Yes   No    Dinner, Wednesday, September 2nd  

 Name (first and last):

Badge Name (if different from above):

Title:  

Mailing Address:    

Street Address:          

City:          State:       Zip: 

Telephone:         Fax:    

E-mail: 

I plan to attend the following meals which are included in my registration fee:

     Yes    No   Lunch, Wednesday, September 2nd

     Yes   No    Dinner, Wednesday, September 2nd   

 Name (first and last):

Badge Name (if different from above):

Title:  

Mailing Address:    

Street Address:          

City:       State:      Zip: 

Telephone:      Fax:  

E-mail: 

I plan to attend the following meals which are included in my registration fee:

     Yes    No   Lunch, Wednesday, September 2nd

     Yes   No    Dinner, Wednesday, September 2nd    

Total number of people attending the 2009 Symposium from your cooperative:   

This page was last updated on June 18, 2009       Copyright 2006, Kansas State University

  

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