Register By Mail

Please submit this entire page for your registration. For multiple registrations, please duplicate this form.

Which event are you attending?

[  ] $265.00 AMROA Summer Conference, Early Bird Rate (expires May 12, 2025)

[  ] $285.00 AMROA Summer Conference, Standard Rate (starts May 13, 2025)

Registration Information:

[ ]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:____________________________

Do you have any dietary restrictions? Yes [ ] No [ ]

Do you have ADA needs? Yes [ ] No [ ]

A cancellation charge of 100% of the registration fee will be assessed on cancellations occurring within seven (7) days of the start of this session. Refunds will not be granted after the program has begun. The University of Alabama reserves the right to cancel, postpone or combine class sections, to limit registration or to change instructors. To cancel your registration, contact the Registration Services department at 205-348-3000 or registration_services@ua.edu. View the OTIDE Cancellation Policy online.