Printable Form (please use your browser’s print icon to print)
Mail To:
Registration Services
The University of Alabama
Box 870388
Tuscaloosa, AL 35487
Which event are you attending?
[ ] In-person: Spring Municipal Clerks Training Institute CS-2305-MCSI01-01: May 3 – 5, 2023, Bryant Conference Center, Registration: $285 (Early Bird of $265 until 4/15/2023)
[ ] Live-Stream: Spring Municipal Clerks Training Institute CS-2305-MCSI01-02: May 3 – 5, 2023, Bryant Conference Center, Registration: $285 (Early Bird of $265 until 4/15/2023)
[ ] In-Person: Fall Municipal Clerks Training Institute CS-2309-MCFI01-01: September 6-8, 2023, Bryant Conference Center, Registration: $285 (Early Bird of $265 until 8/31/2023)
[ ] Live-Stream: Fall Municipal Clerks Training Institute CS-2309-MCFI01-02: September 6-8, 2023, Bryant Conference Center, Registration: $285 (Early Bird of $265 until 8/31/2023)
Which credential do you need?
[ ] Seeking CMC
[ ] Seeking MMC
[ ] Maintenance Hours
[ ]Mr. [ ]Ms. [ ]Dr. First:____________________________Middle Initial:________Last:____________________________
Preferred Name/Nickname:____________________________
Company/Organization Name:____________________________
Mailing Address:____________________________City:____________________________State:________Zip:______________
Email Address:____________________________Phone:____________________________
Job Title:____________________________
[ ] Enclosed is a check for $____________________________ made payable to THE UNIVERSITY OF ALABAMA
[ ] Purchase order is attached.
[ ] Charge $____________________________to credit card: [ ] MasterCard [ ] VISA [ ] American Express [ ] Discover
Card #____________________________Exp. Date (M/Y)____________________________
Security / Verification / CVV Code____________________________(Three or four digit code on back or front of credit card.)
Authorizing Signature:____________________________