LOUISIANA ANIMAL CONTROL TRAINING CLASS

AND CHEMICAL CAPTURE CERTIFICATION CLASS

REGISTRATION INFORMATION

* * * Registration form is  located on page 3 * * *

REGISTRATION FEE FOR ONLY CHEMICAL CAPTURE CLASS $ 200.00 (INCLUDES LACA DUES)

REGISTRATION FEE FOR LACA TRAINING $200.00 (INCLUDES LACA T-SHIRT, LAPEL PIN, NEWSLETTER AND MEMBERSHIP TO N.A.C.A)

REGISTRATION FEE FOR BOTH CLASSES $300.00 (INCLUDES LACA T-SHIRT, LAPEL PIN, NEWSLETTER AND MEMBERSHIP TO N.A.C.A)

NEED CONTINUING EDUCATION HOURS? ONLY $100.00 A DAY.

PLEASE PRINT CLEARLY AND FILL OUT REGISTRATION FORM ON PAGE 3.

ANNUAL MEMBERSHIP DUES ARE ONLY $50.00. IF YOU DO NOT ATTEND L.A.C.A. TO REMAIN A MEMBER YOU MUST PAY YOUR DUES.

MAIL TO:

OFFICE OF CONTINUING EDUCATION

SCHOOL OF VETERINARY MEDICINE

LOUISIANA STATE UNIVERSITY

BATON ROUGE, LA. 70803

 MAKE CHECK PAYABLE TO: LOUISIANA ANIMAL CONTROL ASSOCIATION    

What about Hotel information?

Hotel of Choice FOR 2011

Embassy Suites

4914 CONSTITUTION AVENUE

bATON rOUGE, la. 70808

PHONE 225-924-6566

FAX 225-927-2816

WEBSITE: www.BatonRougeEmbassySuites.com

YOU MUST MENTION THAT THE ROOMS ARE FOR THE LACA CONFERENCE, AND YOU MUST MAKE ARRANGEMENTS AS SOON AS POSSIBLE!! CUTOFF DATE FOR RESERVATIONS AT THIS PRICE AND LOCATION IS NOT KNOWN AT THIS TIME. HURRY AND RESERVE YOUR ROOM TO ENSURE YOU ARE LOCKED IN AT THIS HOTEL!!

REGISTRATION FORM

2011 Louisiana Animal Control Association Conference,

Chemical Capture Course & Continuing Education

NAME________________________________________________________________

ADDRESS_____________________________________________________________

CITY, STATE, PARISH, ZIP______________________________________________

HOME NUMBER (        )            -                WORK NUMBER (        )            -         __

FAX  NUMBER (        )            -                    CELL NUMBER (         )          -               

PLACE OF EMPLOYMENT____________________________________________

EMPLOYER STREET ADDRESS________________________________________    

EMPLOYER CITY, STATE, ZIP_________________________________________                                                          

YOUR OFFICIAL JOB TITLE___________________________________________

E-MAIL ADDRESS____________________________________________________

___CHEMICAL CAPTURE ONLY ($200)         ___LACA MEETING ONLY ($200)           

___LACA & CHEMICAL CAPTURE ($300)      ___THURSDAY ONLY ($100)

___FRIDAY ONLY ($100)                                    ___SATURDAY ONLY ($100)

___ MEMBERSHIP DUES ( $50.00 )

_____YES! I WILL ATTEND THE EVENING SOCIAL, FRIDAY, AUG. 5th 2011.

_____NO, SORRY. I WILL NOT BE ABLE TO ATTEND THE SOCIAL.

Thank you for taking the time to visit our site!!

For problems or questions regarding this web site, contact mail@lacainfo.org

Last updated: 06/22/2011