LOUISIANA ANIMAL CONTROL CERTIFICATION ACADEMY

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, ACCESS TO NEWSLETTER AND MEMBERSHIP TO NACA)

REGISTRATION FEE FOR BOTH CLASSES $300.00 (INCLUDES LACA T-SHIRT, LAPEL PIN, ACCESS TO NEWSLETTER AND MEMBERSHIP TO NACA)

NEED CONTINUING EDUCATION HOURS? ONLY $100.00 A DAY.

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

MAIL TO:

OFFICE OF PUBLIC PROGRAMS     

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 2008:

hOLIDAY iNN

9940 aIRLINE hIGHWAY

bATON rOUGE, la. 70816-8199

    225.924.7021 PHONE

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 for

2008 Louisiana Animal Control Association Conference,

Chemical Capture Course & Continuing Education

NAME_________________________________________

ADDRESS______________________________________

_______________________________________________

CITY, STATE, PARISH, ZIP_______________________

______________________________________________

HOME NUMBER (        )            -               

WORK NUMBER (        )            -               

FAX  NUMBER     (        )            -               

PLACE OF EMPLOYMENT__________________________________

EMPLOYER STREET ADDRESS                                                              

EMPLOYER CITY, STATE, ZIP                                                               

YOUR OFFICIAL JOB TITLE_________________________________

E-MAIL ADDRESS (IF AVAILABLE)___________________________

_____YES! OF COURSE  I WILL ATTEND THE EVENING SOCIAL !

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

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

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Last updated: 03/31/2008