b"FULL REGISTRATION (INCLUDES TICKETS TO SPECIAL EVENTS.) Name(As i should appear on badge.)M MemberNonmemberSpouse / GuestTotals tRCA Amount in parenthesis ($)is post 9/9/96 (price$125 ( 150)$175 (200)$125 (150) on-site) I.000 2.000 3.000 4.000 TRADE SHOW ONLY REGISTRATION/ SPECIAL EVENT TICKETS NameMRCA MemberNonmemberThemeOpeningSpouse Tour rida riday (As it should appear on badge.)FridaySaturdayF ySaturdayPartyLuncheonF Saturday Amount in parenthesis($)is post$30 (35)$30 (35)$40 (45)$40 (45)$50 (55)$35 (55)$35 (40)$40 (45) 9/9/96 (on-site) price I.____________00000 _ 000 2. _ _ ___________00000000 3._00000000 ___________ 4.____________ _ 00000000 SPECIAL REGISTRATION OPTIONS ALS NameCERTInstructor TrainingSpecialI Day MemberSpecial FAI Session (As it should appear on badge.)MemberNonmemberAfter 2 FullBonus Sunday Program $75$100$20Member $1 / Nonmember $225 75 I. - - 00000 2. - - - 00000 3.- - _ ______________00000 4, - - 00000 1( registering additional persons, please use o photocopy of this form. Check here ifofabove attendees have a disability which would require special accommodations to fully participate. anythe STEP5.PAYMENT INFORMATIONSUBTOTAL: 0Check Enclosed (Payable to MRCA) O VISA O Master Card O AMEX Exp.Date: _ _ _____Dues(OPTIONAL)Card Number ______ ___________ _ _ _______Name on Card_______________________Signature ____________________________STEP6.RETURN COMPLETED FORM TO MRCA: Midwest Roofing Contractors AssociationTOTAL AMOUNT DUE 4840 WEST 15TH STREET, SUITEI 000LAWRENCE,KANSAS 66049-3876 3/8r TEL. 9 I'888FAX: 913/843-7555"