On-line Registration

Tennessee County Services Association

Mayors/Executives, County
Commissioners and County
Highway Officials since 1954

2013 POST LEGISLATIVE CONFERENCE
ON-LINE REGISTRATION FORM

County

Name

Title

Street

City, St, Zip

Email:

Early Bird Registration Fees
prior to May 17, 2013

Late / Onsite Registration Fees
after May 17, 2013

County Official

$70

$95

$25

Spouse/Children 12 up

Spouse

$40

$80

$105

All Others

YOU MUST PROVIDE AN EMAIL ADDRESS IF YOU WISH TO RECEIVE
CONFIRMATION OF YOUR REGISTRATION AND PAYMENT.

After filling out all boxes above and checking the appropriate
registration fee, please print a copy for your records before hitting
the "Submit" button to the right.

If you are registering more than one person on-line, please register
each person separately so that we may prepare name badges for
each person, including spouses/guests. Thank You.

To pay by credit card (VISA, MasterCard, or AmEx) please call Adam in the TCSA office at
615-532-3767.