Pay By Check Registration Form

Registration Deadline is 8/31/06

National Court Collections Conference

September 18-20, 2006

Golden Nugget Hotel
Las Vegas, Nevada

Instructions: Please fill out, print, and submit this registration form for your organization's primary member, and each additional staff member that will be attending the conference.

Attendee Information
Name of Organization:
Name:
Title:
Address
Street Line1:
Street Line2:
City:
State:
Zip code:
Contact Information
Business Phone:
Fax:
Reply to/Email:

Individual and Vendor Registration
Registration Type:	(All non-governmental agencies and firms must register as one of the vendor types)
Payment Form:	I will be mailing a check to the address below (must be received by 8/31/06)
Vendor Sponsorship
My organization will sponsor or help sponsor:	Meet and Greet Break

Cancellation Policy: Registration Fee is non-refundable

Make checks payable to GCAT.
Mail payment and registration to Lorena Gomez
c/o Montgomery County Collections
P.O. Box 2178
Conroe, Texas 77305.

You may pre-register by submitting this online form or by faxing a printout of this form or confirmation to (936) 538-8057 (Registration fees on pre-registration must be received no later than 8/31/06). Please make your own hotel reservation(s) no later than 8/25/06 by calling (800) 634-3454. Ask for the special National Court Collections Conference rate. The Golden Nugget hotel requires one room night deposit upon registration. For additional details contact Nadine Jenkins at (281) 748-3484.

ALL REGISTRATIONS ARE NON-REFUNDABLE