MoVA Conference
March 24-26, 2010
The Capitol  Plaza
415 W McCarty, Jefferson City, 65101
573-635-1234
Room rate: $89

REGISTRATION AND INVOICE FORM

Name: _______________________________Spouse (if attending) _________________
Organization: ____________________________________________________________
Mailing Address: _________________________________________________________
City, State, Zip: __________________________________________________________
Day Telephone: ____________ Fax: ________________ E-mail: __________________
Please Indicate Any Special Needs: ___________________________________________

Conference registration fee includes the luncheons on Wednesday and Thursday, breakfast on Friday, all scheduled breaks and the conference informational packet.

Full Conference Fee:                            MoVA Member    Non-Member
Early Registration                                     _____ $100.00     _____ $175.00
Late Registration (received after 2/28/10) _____ $150.00     _____ $225.00

One Day Conference Fee:                   MoVA Member    Non-Member
Early Registration                                     _____ $60.00       _____ $80.00
Late Registration (received after 2/28/10) _____ $100.00     _____ $130.00
Please indicate which day you will be attending. _____24th _____25th

Student Rates:
Early Registration                                     _____ $75.00
Late Registration (received after 2/28/10) _____ $125.00

Total Fees Included: ________________ Purchase Order No. __________________

Please return the completed Registration & Invoice Form with the appropriate fees (payable to MoVA) to:

Missouri Victim Assistance Network (MoVA)
ATTN: Conference
P.O. Box 2232
Jefferson City, MO  65102

Registrations will not processed if not accompanied by full fees.
Cancellation deadline is February 28, 2010. Fees are not refundable after that date!
Hotel Reservation deadline is February 18, 2010.